No office rate
27640 is partial excision of the tibia; 27641 is partial excision of the fibula. Select according to the bone documented in the operative report.
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CMS RVU26D · Effective 2026-10-01
27641 Fibula excision Medicare reimbursement rates in Iowa
Reports surgical removal of part of the fibula, commonly to excise diseased bone such as a focus of osteomyelitis. Compare 27641 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 27641 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
$558.64
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 27641: Partial excision of fibula
Reports surgical removal of part of the fibula, commonly to excise diseased bone such as a focus of osteomyelitis.
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.
CMS billing rules for 27641
- 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
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU9.59 · 53%
- Practice expense (office) RVU7.13 · 39%
- Malpractice RVU1.54 · 8%
1.1K
Medicare services in 2024 · #2906 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.
27641 compared with similar codes
Office rates for Iowa, from the same CMS release.
No office rate
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.
No office rate
27646 is for resection of a fibular tumor. 27641 is for partial fibular excision, not the tumor-resection service.
Compare 27641 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
$558.64
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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 27641 in Iowa.
PPRRVU2026_Oct_nonQPP.csv
2,988
- Code
- 27641
- Physician work
- 9.59
- Practice expense
- 7.13
- Malpractice
- 1.54
GPCI2026.csv
53
- Locality
- Iowa
- Physician work
- 1.000
- Practice expense
- 0.915
- Malpractice
- 0.397
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 9.59 | × 1.000 | 9.5900 |
| Practice expense | 7.13 | × 0.915 | 6.5240 |
| Malpractice | 1.54 | × 0.397 | 0.6114 |
| Total RVUs | 16.7253 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Iowa$558.64
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 9.59 | 1 |
| Practice expense | 7.13 | 0.915 |
| Malpractice | 1.54 | 0.397 |
(9.59 × 1 + 7.13 × 0.915 + 1.54 × 0.397) × $33.4009 = $558.64
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.
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 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.
2,98527637,,Remove/graft leg bone lesion,A,,10.05,9.14,NA,9.14,,2.00,21.19,21.19,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,98627638,,Remove/graft leg bone lesion,A,,10.72,8.26,NA,8.26,,1.94,20.92,20.92,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,98727640,,Partial removal of tibia,A,,11.93,8.90,NA,8.90,,2.18,23.01,23.01,0,090,0.10,0.69,0.21,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,98827641,,Partial removal of fibula,A,,9.59,7.13,NA,7.13,,1.54,18.26,18.26,0,090,0.10,0.69,0.21,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,98927645,,Resect tibia tumor,A,,26.53,15.41,NA,15.41,,5.64,47.58,47.58,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,99027646,,Resect fibula tumor,A,,22.63,14.16,NA,14.16,,4.82,41.61,41.61,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,99127647,,Resect talus/calcaneus tum,A,,19.75,5.73,NA,5.73,,1.68,27.16,27.16,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,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