No office rate
Both concern ankle arthrotomy services. Choose based on the procedure actually documented and the complete CPT descriptor, rather than the shared ankle-joint context.
On this page
CMS RVU26D · Effective 2026-10-01
27612 Ankle exploration Medicare reimbursement rates in Massachusetts
Reports open surgical exploration of the ankle joint when the operative service is inspection of the joint rather than a separately defined procedure. Compare 27612 office and facility rates across CMS payment localities in Massachusetts.
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 27612 in Massachusetts?
Massachusetts has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$549.61–$593.15
2 of 2 localities have a supported rate.
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 27612: Open ankle joint exploration
Reports open surgical exploration of the ankle joint when the operative service is inspection of the joint rather than a separately defined procedure.
Ankle joint exploration uses an open surgical approach to expose and inspect the joint. Orthopedic surgeons, including foot and ankle specialists, may perform it in an operating room when examination or imaging has not established the source of an intra-articular problem, or when direct inspection is needed during surgery. The operative report should identify the ankle joint explored, the reason for exploration, the approach, and the findings or actions taken.
Select this code when the documented service supports ankle joint exploration, rather than a more specific procedure such as removal of joint lining or biopsy of a lower-leg soft-tissue mass. Medicare assigns a 90-day global period, which includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. For bilateral reporting with modifier 50, payment is 150%. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 27612
- 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 RVU7.95 · 49%
- Practice expense (office) RVU7.01 · 43%
- Malpractice RVU1.25 · 8%
463
Medicare services in 2024 · #3628 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.
27612 compared with similar codes
Office rates for Massachusetts, from the same CMS release.
No office rate
This is another ankle joint exploration or treatment code. The operative details and the complete descriptor determine which code fits.
No office rate
Use the synovectomy code when the surgeon removes ankle joint lining; exploration alone is distinct from that tissue-removal work.
$269.20–$297.08
This code concerns biopsy of lower-leg soft tissue. It is not the ankle joint exploration code when the target is intra-articular.
Compare 27612 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.
2 of 2 payment localities
Metropolitan Boston →
Office / nonfacility
Unavailable
Facility
$593.15
Rest Of Massachusetts →
Office / nonfacility
Unavailable
Facility
$549.61
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27612 billing questions
How is this different from an ankle synovectomy?
This code describes exploration of the ankle joint. When the operative work removes joint lining, consider the ankle synovectomy code that matches the documented extent.
What should the operative report document?
Document the ankle joint explored, the clinical reason for direct inspection, the surgical approach, and the findings and work performed.
Does the code have a global period?
Yes. Medicare assigns a 90-day global period that includes the day-before preoperative visit and 90 days of related postoperative care.
How is bilateral exploration reported?
For bilateral procedures, report modifier 50; CMS payment is 150%.
Can an assistant or co-surgeon be paid?
An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
What happens when another procedure is performed in the same session?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction to 50%.
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.
2,96827606,,Incision of achilles tendon,A,,4.08,2.90,NA,2.90,,0.65,7.63,7.63,0,010,0.10,0.80,0.10,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,96927607,,Treat lower leg bone lesion,A,,8.40,6.93,NA,6.93,,1.65,16.98,16.98,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,97027610,,Explore/treat ankle joint,A,,8.90,7.71,NA,7.71,,1.64,18.25,18.25,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,97127612,,Exploration of ankle joint,A,,7.95,7.01,NA,7.01,,1.25,16.21,16.21,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,97227613,,Biopsy lower leg soft tissue,A,,2.16,5.32,,2.03,,0.33,7.81,4.52,0,010,0.10,0.80,0.10,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,97327614,,Biopsy lower leg soft tissue,A,,5.66,11.69,,5.15,,0.92,18.27,11.73,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,97427615,,Resect leg/ankle tum < 5 cm,A,,15.33,9.61,NA,9.61,,3.29,28.23,28.23,0,090,0.10,0.69,0.21,2,1,0,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00