No office rate
27641 describes partial removal of the fibula. Use 27646 when the documented operation is resection of a fibular tumor.
On this page
CMS RVU26D · Effective 2026-10-01
27646 Bone tumor resection Medicare reimbursement rates in Ohio
Reports operative resection of a tumor involving the fibula, typically by an orthopedic surgeon when the treatment requires removal of the affected bone segment. Compare 27646 office and facility rates across CMS payment localities in Ohio.
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 27646 in Ohio?
Ohio 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
$1349.95
1 of 1 localities have a supported rate.
Payment area: Ohio
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 27646: Fibular tumor resection
Reports operative resection of a tumor involving the fibula, typically by an orthopedic surgeon when the treatment requires removal of the affected bone segment.
This code represents operative resection of a tumor involving the fibula, rather than a limited sampling procedure. It is typically performed by an orthopedic surgeon, often an orthopedic oncologist, in a hospital operating room for a primary or metastatic bone tumor requiring removal of the involved portion of the fibula. The operative report should identify the fibular site and describe the resection performed.
Choose the code based on the operation documented, not tumor size alone: distinguish tumor resection from a more limited lesion removal or partial fibular excision. Document the diagnosis, laterality, extent of bone removed, and any reconstruction performed. CMS assigns a 90-day global period, including the day-before preoperative visit and 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 multiple-procedure reduction. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 27646
- 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 RVU22.63 · 54%
- Practice expense (office) RVU14.16 · 34%
- Malpractice RVU4.82 · 12%
17
Medicare services in 2024 · #5999 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.
27646 compared with similar codes
Office rates for Ohio, from the same CMS release.
No office rate
27635 is for removal of a lower-leg bone lesion. Distinguish it from 27646 by the documented tumor-resection service and the fibular site.
No office rate
Both codes describe tumor resection, but 27645 is for the tibia and 27646 is for the fibula.
No office rate
27637 describes lower-leg bone lesion removal with grafting. Choose 27646 when the documented service is fibular tumor resection.
Compare 27646 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
Ohio →
Office / nonfacility
Unavailable
Facility
$1349.95
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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 27646 in Ohio.
PPRRVU2026_Oct_nonQPP.csv
2,990
- Code
- 27646
- Physician work
- 22.63
- Practice expense
- 14.16
- Malpractice
- 4.82
GPCI2026.csv
85
- Locality
- Ohio
- Physician work
- 1.000
- Practice expense
- 0.913
- Malpractice
- 1.008
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 22.63 | × 1.000 | 22.6300 |
| Practice expense | 14.16 | × 0.913 | 12.9281 |
| Malpractice | 4.82 | × 1.008 | 4.8586 |
| Total RVUs | 40.4166 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Ohio$1349.95
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 22.63 | 1 |
| Practice expense | 14.16 | 0.913 |
| Malpractice | 4.82 | 1.008 |
(22.63 × 1 + 14.16 × 0.913 + 4.82 × 1.008) × $33.4009 = $1349.95
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.
27646 billing questions
How is this different from code 27641?
Code 27646 describes resection of a fibular tumor. Code 27641 describes partial removal of the fibula; select according to the documented procedure and its purpose.
How is this different from code 27635?
Code 27635 covers removal of a lower-leg bone lesion. Use 27646 when the operative service is a tumor resection involving the fibula, rather than a more limited lesion-removal procedure.
What documentation supports reporting 27646?
The operative report should identify the fibula as the tumor site and describe the extent of bone resected, laterality, and any reconstruction performed.
How are bilateral procedures reported?
For a bilateral procedure performed in the same session, report modifier 50; CMS pays the bilateral procedure at 150%.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be available. Co-surgeon payment requires supporting documentation; team surgery is not permitted under the CMS facts 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.
2,98727640,,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
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
8213282,NY,99,REST OF NEW YORK,1.000,0.950,0.703
8311502,NC,00,NORTH CAROLINA,1.000,0.933,0.639
8403302,ND,01,NORTH DAKOTA**,1.000,1.000,0.406
8515202,OH,00,OHIO,1.000,0.913,1.008
8604312,OK,00,OKLAHOMA,1.000,0.893,0.777
8702302,OR,01,PORTLAND,1.016,1.111,0.744
8802302,OR,99,REST OF OREGON,1.000,0.996,0.703