No office rate
Both describe open ankle synovectomy through arthrotomy. Select 27626 when the documentation supports extensive removal; 27625 represents the less extensive procedure.
On this page
CMS RVU26D · Effective 2026-10-01
27626 Ankle synovectomy Medicare reimbursement rates in Pennsylvania
Reported for open removal of extensive abnormal synovial tissue from the ankle joint, such as in chronic proliferative or inflammatory synovitis. Compare 27626 office and facility rates across CMS payment localities in Pennsylvania.
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 27626 in Pennsylvania?
Pennsylvania 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
$543.37–$587.21
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 27626: Extensive ankle synovectomy through arthrotomy
Reported for open removal of extensive abnormal synovial tissue from the ankle joint, such as in chronic proliferative or inflammatory synovitis.
An orthopedic surgeon uses an open approach to remove extensive diseased synovial tissue from the ankle joint. This may be performed for persistent proliferative synovitis, including synovitis associated with inflammatory arthritis, when the surgeon determines that a broad synovectomy is needed. The arthrotomy provides access to the joint; tissue sampling performed as part of the procedure is included in the service. This is an open operation, distinct from arthroscopic synovectomy.
Choose this code when the operative report supports an extensive synovectomy, rather than the less extensive procedure represented by 27625. Document the affected ankle, the approach, the distribution and extent of abnormal synovium removed, and the reason for surgery. The service has a 90-day global period, including 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 other procedures are subject to the standard 50% reduction. Bilateral reporting with modifier 50 is paid at 150%. An assistant at surgery may be paid; co-surgeons and team surgery are not permitted.
CMS billing rules for 27626
- 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 not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU8.87 · 53%
- Practice expense (office) RVU6.69 · 40%
- Malpractice RVU1.33 · 8%
320
Medicare services in 2024 · #3949 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.
27626 compared with similar codes
Office rates for Pennsylvania, from the same CMS release.
No office rate
This code is for extensive synovectomy. Use 27620 when the open ankle-joint work is exploration or another covered treatment without the extensive synovectomy.
Compare 27626 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 Philadelphia →
Office / nonfacility
Unavailable
Facility
$587.21
Rest Of Pennsylvania →
Office / nonfacility
Unavailable
Facility
$543.37
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27626 billing questions
How do I distinguish 27626 from 27625?
Use 27626 when the operative documentation supports an extensive ankle synovectomy. Use 27625 for the less extensive open synovectomy.
Can the biopsy performed during the arthrotomy be billed separately?
Biopsy performed as part of this ankle synovectomy is included in the service. The operative note should describe the synovium removed and any tissue submitted for examination.
Can 27626 be reported for an arthroscopic synovectomy?
No. This code describes an open synovectomy through arthrotomy; arthroscopic ankle synovectomy codes distinguish partial from major synovectomy.
What modifiers and payment rules should I check?
Modifier 50 applies to bilateral reporting, which CMS pays at 150%. The procedure has a 90-day global period, and same-session multiple procedures are subject to the standard reduction.
May an assistant or co-surgeon be reported?
CMS permits payment for an assistant at surgery. 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 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.
2,97727619,,Exc leg/ankle tum deep <5 cm,A,,6.74,5.19,NA,5.19,,1.13,13.06,13.06,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,97827620,,Explore/treat ankle joint,A,,6.00,6.01,NA,6.01,,1.03,13.04,13.04,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,97927625,,Remove ankle joint lining,A,,8.28,6.79,NA,6.79,,1.34,16.41,16.41,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,98027626,,Remove ankle joint lining,A,,8.87,6.69,NA,6.69,,1.33,16.89,16.89,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,98127630,,Removal of tendon lesion,A,,4.82,11.44,,4.84,,0.72,16.98,10.38,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,98227632,,Exc leg/ankle les sc 3 cm/>,A,,5.76,4.79,NA,4.79,,1.22,11.77,11.77,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,98327634,,Exc leg/ankle tum dep 5 cm/>,A,,9.88,6.86,NA,6.86,,1.92,18.66,18.66,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00