No office rate
27052 samples the hip joint; 27050 samples the sacroiliac joint. Select based on the joint from which tissue is obtained.
On this page
CMS RVU26D · Effective 2026-10-01
27052 Joint biopsy Medicare reimbursement rates in Iowa
Surgical biopsy of hip joint tissue is reported when a clinician needs a diagnostic specimen to investigate an unexplained joint process. Compare 27052 office and facility rates across CMS payment localities in Iowa.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 27052 in Iowa?
Iowa has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$503.21
1 of 1 localities have a supported rate.
Payment area: Iowa
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Orthopedic surgery
About 27052: Hip joint biopsy
Surgical biopsy of hip joint tissue is reported when a clinician needs a diagnostic specimen to investigate an unexplained joint process.
A surgeon obtains tissue from inside the hip joint for diagnostic evaluation, commonly when infection, inflammatory disease, or another unexplained joint abnormality requires tissue assessment. The specimen may be submitted for pathology and, when clinically indicated, microbiology. Orthopedic surgeons typically perform this procedure in a facility operating room rather than an office setting.
Report 27052 when the specimen is taken from the hip joint itself, not from nearby soft tissue or a bone lesion. The operative report should identify the joint sampled, the tissue obtained, the diagnostic reason, and the procedure performed. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care. In a same-session multiple-procedure situation, the highest-valued procedure is paid in full and other procedures at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 27052
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral procedure with modifier 50 is paid at 150%.
- Assistant at surgery
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU7.23 · 43%
- Practice expense (office) RVU7.90 · 47%
- Malpractice RVU1.53 · 9%
43
Medicare services in 2024 · #5444 by national volume
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.
27052 compared with similar codes
Office rates for Iowa, from the same CMS release.
$313.60
27040 is for superficial soft-tissue biopsy in the pelvis or hip area. Use 27052 when the specimen comes from inside the hip joint.
No office rate
27041 describes deep soft-tissue biopsy in the pelvis or hip area, not biopsy of the hip joint itself.
No office rate
27052 obtains a diagnostic specimen from the hip joint. 27054 describes removal of hip joint lining rather than a limited biopsy.
Compare 27052 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Iowa →
Office / nonfacility
Unavailable
Facility
$503.21
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 27052 in Iowa.
PPRRVU2026_Oct_nonQPP.csv
2,728
- Code
- 27052
- Physician work
- 7.23
- Practice expense
- 7.90
- Malpractice
- 1.53
GPCI2026.csv
53
- Locality
- Iowa
- Physician work
- 1.000
- Practice expense
- 0.915
- Malpractice
- 0.397
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 7.23 | × 1.000 | 7.2300 |
| Practice expense | 7.90 | × 0.915 | 7.2285 |
| Malpractice | 1.53 | × 0.397 | 0.6074 |
| Total RVUs | 15.0659 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Iowa$503.21
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 7.23 | 1 |
| Practice expense | 7.9 | 0.915 |
| Malpractice | 1.53 | 0.397 |
(7.23 × 1 + 7.9 × 0.915 + 1.53 × 0.397) × $33.4009 = $503.21
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
27052 billing questions
How is a hip joint biopsy different from a biopsy of nearby soft tissue?
Use 27052 for tissue obtained from within the hip joint. Codes 27040 and 27041 describe biopsies of soft tissue in the pelvis or hip area, rather than joint tissue.
When would 27050 be reported instead?
27050 is for biopsy of the sacroiliac joint. The sampled joint determines which biopsy code applies.
What documentation supports 27052?
The operative report should identify the hip joint as the sampling site, describe the tissue obtained, and document the clinical reason for obtaining a diagnostic specimen.
How is bilateral hip joint biopsy handled under the CMS rules?
CMS identifies this as a bilateral procedure and pays reporting with modifier 50 at 150%.
What global and multiple-procedure rules apply?
The code has a 90-day global period that includes the day-before preoperative visit and related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others at 50%.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
2,72527048,,Exc hip/pelv tum deep < 5 cm,A,,8.63,6.93,NA,6.93,,2.01,17.57,17.57,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,72627049,,Resect hip/pelv tum < 5 cm,A,,21.01,13.20,NA,13.20,,4.47,38.68,38.68,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,72727050,,Biopsy of sacroiliac joint,A,,4.62,6.35,NA,6.35,,1.00,11.97,11.97,0,090,0.10,0.69,0.21,2,1,0,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,72827052,,Biopsy of hip joint,A,,7.23,7.90,NA,7.90,,1.53,16.66,16.66,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,72927054,,Removal of hip joint lining,A,,8.98,8.61,NA,8.61,,1.91,19.50,19.50,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,73027057,,Buttock fasciotomy w/dbrdmt,A,,14.54,9.94,NA,9.94,,3.09,27.57,27.57,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,73127059,,Resect hip/pelv tum 5 cm/>,A,,28.62,14.36,NA,14.36,,6.23,49.21,49.21,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5006102,IL,15,SUBURBAN CHICAGO,1.007,1.027,1.772
5106102,IL,99,REST OF ILLINOIS,1.000,0.913,1.563
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915
5607202,LA,01,NEW ORLEANS,1.000,0.941,1.136