Billing code 27704: Ankle implant removalMedicare rate & RVUs in Nevada
Reports operative removal of an ankle joint prosthetic implant, such as when a failed or infected ankle replacement is explanted.
CMS doesn’t publish an office rate for 27704 in Nevada.
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 27704 covers
27704 represents operative removal of a prosthetic implant from the ankle joint, such as explantation of components from a prior total ankle replacement. An orthopedic surgeon, often a foot-and-ankle specialist, may perform the procedure for a failed or infected implant. A staged explant for infection, with replacement planned for a later operation, is a typical clinical situation. This is distinct from removing fixation screws or plates from bone.
Report the code when the operative record supports removal of the ankle joint implant; document the indication and which components were removed. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in one session, the highest-valued procedure is paid in full and others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Medicare does not pay an assistant at surgery; 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.
27704 in Nevada**
| Payment locality | Office | Facility |
|---|---|---|
| Nevada** | Unavailable | $522.33 |
How the 27704 rate is calculated
Each of 27704’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 · 27704
RVUs × geographic indexes × conversion factor
Work7.61
7.61 RVUs× 1.000 GPCI
Practice expense6.93
6.93 RVUs× 1.000 GPCI
Malpractice1.31
1.31 RVUs× 1.000 GPCI
Adjusted RVUs
15.8500
Conversion factor
$33.4009
Medicare rate
$529.40
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 27704
27704 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 27704
Ankle implant removal
| 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 · 27704
Ankle implant removal
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
27704 without 50 · national facility
$529.40
Ankle implant removal
27704-50 · Bilateral: 150%
$794.10
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).
27704 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 20680Implant removal
- Choose 27704 for removal of an ankle joint prosthesis. Use 20680 for deep fixation hardware, such as screws or plates, when that is the material being removed.
- 27703Ankle revision
- 27704 describes removal of the ankle implant. 27703 is considered when the procedure revises the total ankle replacement rather than removing the implant alone.
- 27702Ankle replacement
- 27702 describes an ankle replacement procedure with an implant; 27704 is for removing a previously implanted ankle prosthesis.
27704 billing questions
How is 27704 different from 20680?
27704 is for removal of an ankle joint prosthetic implant. 20680 is generally used for removal of deep fixation hardware, such as screws or plates, rather than an ankle joint replacement.
Should 27704 be reported when an ankle replacement is revised?
When the operation revises the ankle replacement, consider the revision service, such as 27703, rather than treating implant removal as the only service. The operative work and applicable coding edits determine whether removal is separately reportable.
What documentation supports 27704?
Document the reason for explantation, the ankle implant being removed, and the components taken out. For a staged procedure, the record should distinguish the removal operation from any later reconstruction.
How does Medicare handle bilateral reporting?
For bilateral ankle implant removal reported with modifier 50, CMS pays 150% under the stated bilateral rule.
Can an assistant or co-surgeon be reported?
Medicare does not pay an assistant at surgery for this code. Co-surgeons are paid only when supporting documentation is provided; 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 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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