Billing code 27647: Bone tumor resectionMedicare rate & RVUs in Oregon
Reports operative resection of a tumor involving the talus or calcaneus, the hindfoot bones, when the surgeon removes the affected bone tissue.
CMS doesn’t publish an office rate for 27647 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 27647 covers
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.
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 27647 pays more and less in Oregon
| Payment locality | Office | Facility |
|---|---|---|
| Portland | Unavailable | $924.60 |
| Rest Of Oregon | Unavailable | $889.74 |
How the 27647 rate is calculated
Each of 27647’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 · 27647
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 19.75Practice expense 5.73Malpractice 1.68
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 27647
27647 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 27647
Bone tumor resection
| 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) | 0 | Not permitted. |
| 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 · 27647
Bone tumor resection
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
27647 without 50 · national facility
$907.17
Bone tumor resection
27647-50 · Bilateral: 150%
$1,360.76
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).
27647 compared with similar codes
Compare codes
27647 vs 28100 vs 27645 vs 27646 vs 27635: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 28100Bone lesion excision
- 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.
- 27645Tibial tumor resection
- 27645 applies to tumor resection of the tibia. This code applies when the resected tumor involves the talus or calcaneus.
- 27646Bone tumor resection
- 27646 applies to tumor resection of the fibula. This code applies when the resected tumor involves the talus or calcaneus.
- 27635Bone lesion removal
- 27635 concerns a bone lesion procedure in the lower leg, not tumor resection of the talus or calcaneus.
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 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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