Billing code 27052: Joint biopsyMedicare rate & RVUs in Oregon
Surgical biopsy of hip joint tissue is reported when a clinician needs a diagnostic specimen to investigate an unexplained joint process.
CMS doesn’t publish an office rate for 27052 in Oregon.
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 27052 covers
A surgeon obtains tissue from inside the hip joint for diagnostic evaluation, commonly when infection, inflammatory disease, or another unexplained joint abnormality requires tissue assessment. The specimen may be submitted for pathology and, when clinically indicated, microbiology. Orthopedic surgeons typically perform this procedure in a facility operating room rather than an office setting.
Report 27052 when the specimen is taken from the hip joint itself, not from nearby soft tissue or a bone lesion. The operative report should identify the joint sampled, the tissue obtained, the diagnostic reason, and the procedure performed. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care. In a same-session multiple-procedure situation, 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 payment may be made; co-surgeon payment requires 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.
Where 27052 pays more and less in Oregon
| Payment locality | Office | Facility |
|---|---|---|
| Portland | Unavailable | $576.53 |
| Rest Of Oregon | Unavailable | $540.23 |
How the 27052 rate is calculated
Each of 27052’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 · 27052
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 7.23Practice expense 7.90Malpractice 1.53
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 27052
27052 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 27052
Joint biopsy
| 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) | 2 | Paid. |
| 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 · 27052
Joint biopsy
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
27052 without 50 · national facility
$556.46
Joint biopsy
27052-50 · Bilateral: 150%
$834.69
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).
27052 compared with similar codes
Compare codes
27052 vs 27050 vs 27040 vs 27041 vs 27054: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 27050Joint biopsy
- 27052 samples the hip joint; 27050 samples the sacroiliac joint. Select based on the joint from which tissue is obtained.
- 27040Soft-tissue biopsy
- 27040 is for superficial soft-tissue biopsy in the pelvis or hip area. Use 27052 when the specimen comes from inside the hip joint.
- 27041Soft-tissue biopsy
- 27041 describes deep soft-tissue biopsy in the pelvis or hip area, not biopsy of the hip joint itself.
- 27054Hip synovectomy
- 27052 obtains a diagnostic specimen from the hip joint. 27054 describes removal of hip joint lining rather than a limited biopsy.
27052 billing questions
How is a hip joint biopsy different from a biopsy of nearby soft tissue?
Use 27052 for tissue obtained from within the hip joint. Codes 27040 and 27041 describe biopsies of soft tissue in the pelvis or hip area, rather than joint tissue.
When would 27050 be reported instead?
27050 is for biopsy of the sacroiliac joint. The sampled joint determines which biopsy code applies.
What documentation supports 27052?
The operative report should identify the hip joint as the sampling site, describe the tissue obtained, and document the clinical reason for obtaining a diagnostic specimen.
How is bilateral hip joint biopsy handled under the CMS rules?
CMS identifies this as a bilateral procedure and pays reporting with modifier 50 at 150%.
What global and multiple-procedure rules apply?
The code has a 90-day global period that includes the day-before preoperative visit and related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others at 50%.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; 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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