Billing code 27641: Fibula excisionMedicare rate & RVUs in Georgia
Reports surgical removal of part of the fibula, commonly to excise diseased bone such as a focus of osteomyelitis.
CMS doesn’t publish an office rate for 27641 in Georgia.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 27641 covers
27641 represents an operation that removes a portion of the fibula itself, rather than a soft-tissue lesion near the ankle or lower leg. A typical indication is excision of diseased bone in osteomyelitis. An orthopedic surgeon generally performs the procedure in an operating room, exposing the involved fibular area and removing the documented portion of bone. The operative report should make clear that the fibula was partially excised and identify the site and clinical reason for removal.
Report the code when the documented work is partial fibular excision; distinguish it from partial tibial excision, curettage or excision of a bone lesion, and resection of a fibular tumor. This major surgery has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment is barred by statutory restriction; co-surgeons require supporting documentation, and team surgery is not permitted.
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
Where 27641 pays more and less in Georgia
| Payment locality | Office | Facility |
|---|---|---|
| Atlanta | Unavailable | $625.01 |
| Rest Of Georgia | Unavailable | $594.06 |
How the 27641 rate is calculated
Each of 27641’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 27641
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 9.59Practice expense 7.13Malpractice 1.54
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 27641
27641 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 27641
Fibula excision
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.69/0.21 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 27641
Fibula excision
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
27641 without 50 · national facility
$609.90
Fibula excision
27641-50 · Bilateral: 150%
$914.85
Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).
27641 compared with similar codes
Compare codes
27641 vs 27640 vs 27635 vs 27646: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 27640Tibial bone excision
- 27640 is partial excision of the tibia; 27641 is partial excision of the fibula. Select according to the bone documented in the operative report.
- 27635Bone lesion removal
- 27635 addresses excision or curettage of a bone cyst or benign tumor of the tibia or fibula. 27641 describes partial excision of the fibula, such as removal of diseased bone.
- 27646Bone tumor resection
- 27646 is for resection of a fibular tumor. 27641 is for partial fibular excision, not the tumor-resection service.
27641 billing questions
How is partial fibular excision different from partial tibial excision?
27641 is for partial removal of the fibula. Use 27640 for the corresponding partial excision of the tibia.
When would a bone-lesion code be more appropriate?
Compare 27641 with 27635 when the operation is directed at a bone cyst or benign tumor through excision or curettage. The operative report should establish whether the service was partial excision of fibula or treatment of a specific bone lesion.
What documentation supports 27641?
Document the fibular site, the indication for surgery, and the portion of bone removed. The operative report should support partial excision of the fibula itself.
How does the 90-day global period affect postoperative billing?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period for this major surgery.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment is barred by statutory restriction. Co-surgeons are payable only with supporting documentation; team surgery is not permitted.
How is bilateral surgery or another same-session procedure paid?
Bilateral reporting with modifier 50 is paid at 150%. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and the others are subject to the standard 50% reduction.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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