$591.18
Use 28100 for a more limited curettage or excision of a benign bone lesion in the talus or calcaneus; use 27647 for tumor resection involving those bones.
On this page
CMS RVU26D · Effective 2026-10-01
27647 Bone tumor resection Medicare reimbursement rates in Iowa
Reports operative resection of a tumor involving the talus or calcaneus, the hindfoot bones, when the surgeon removes the affected bone tissue. Compare 27647 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 27647 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
$857.06
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 27647: Talus or calcaneus tumor resection
Reports operative resection of a tumor involving the talus or calcaneus, the hindfoot bones, when the surgeon removes the affected bone tissue.
An orthopedic foot and ankle or musculoskeletal oncology surgeon uses this service to remove a tumor involving the talus or calcaneus. These hindfoot bones may be affected by a primary bone tumor or tumor involving bone from another source. The procedure is performed in an operating room and involves resection of the involved bone, rather than limited scraping of a lesion. The removed tissue is generally submitted for examination by pathology.
Select the code when the operative report documents tumor resection from the talus or calcaneus; identify the bone, laterality, tumor extent, and work performed. A limited curettage or excision of a benign bone lesion may point to a different code. CMS assigns 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 at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery services may be paid; co-surgeons and team surgery are not permitted.
CMS billing rules for 27647
- 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 not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU19.75 · 73%
- Practice expense (office) RVU5.73 · 21%
- Malpractice RVU1.68 · 6%
16
Medicare services in 2024 · #6030 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.
27647 compared with similar codes
Office rates for Iowa, from the same CMS release.
No office rate
27645 applies to tumor resection of the tibia. This code applies when the resected tumor involves the talus or calcaneus.
No office rate
27646 applies to tumor resection of the fibula. This code applies when the resected tumor involves the talus or calcaneus.
No office rate
27635 concerns a bone lesion procedure in the lower leg, not tumor resection of the talus or calcaneus.
Compare 27647 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
$857.06
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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 27647 in Iowa.
PPRRVU2026_Oct_nonQPP.csv
2,991
- Code
- 27647
- Physician work
- 19.75
- Practice expense
- 5.73
- Malpractice
- 1.68
GPCI2026.csv
53
- Locality
- Iowa
- Physician work
- 1.000
- Practice expense
- 0.915
- Malpractice
- 0.397
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 19.75 | × 1.000 | 19.7500 |
| Practice expense | 5.73 | × 0.915 | 5.2430 |
| Malpractice | 1.68 | × 0.397 | 0.6670 |
| Total RVUs | 25.6599 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Iowa$857.06
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 19.75 | 1 |
| Practice expense | 5.73 | 0.915 |
| Malpractice | 1.68 | 0.397 |
(19.75 × 1 + 5.73 × 0.915 + 1.68 × 0.397) × $33.4009 = $857.06
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.
27647 billing questions
How does this differ from curettage of a talus or calcaneus lesion?
This code is for tumor resection involving the talus or calcaneus. A more limited curettage or excision of a benign bone lesion may fit 28100 instead.
Does the code apply to the tibia or fibula?
No. It is specific to the talus or calcaneus. Tumor resection of the tibia or fibula is represented by codes such as 27645 or 27646.
What documentation supports reporting this code?
Document which hindfoot bone contains the tumor, its extent, laterality, and the resection performed. The operative report should distinguish resection from a limited curettage or lesion excision.
How is bilateral surgery reported?
When the procedure is performed bilaterally, CMS lists modifier 50 payment at 150%. The operative documentation should identify the work performed on each side.
Are related postoperative visits included?
Yes. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant surgeon be paid for this procedure?
CMS indicates that an assistant at surgery may be paid. Co-surgeons and team surgery are not permitted for this code.
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.
2,98827641,,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
2,99227648,,Injection for ankle x-ray,A,,0.94,5.11,,0.23,,0.14,6.19,1.31,0,000,0.00,0.00,0.00,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,99327650,,Repair achilles tendon,A,,8.98,8.26,NA,8.26,,1.45,18.69,18.69,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,99427652,,Repair/graft achilles tendon,A,,10.51,6.56,NA,6.56,,1.39,18.46,18.46,0,090,0.10,0.69,0.21,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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