Billing code 27499: Unlisted procedureMedicare rate & RVUs in Texas
Report this code for a femur or knee operation, including an unusual decompression technique, when no more specific code describes the service.
CMS doesn’t publish an office rate for 27499 in Texas.
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 27499 covers
This code represents an operation on the femur or knee that lacks a more specific code. It may be appropriate for an unusual thigh or knee decompression technique that is not described by a dedicated code. Orthopedic surgeons typically perform these procedures in an operating room; the operative report should identify the anatomy treated, the condition addressed, the technique, and the work performed.
Submit a clear narrative describing the service and supporting operative documentation so the work can be evaluated against a comparable service. Use a specific code instead when it accurately describes the operation. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and others at 50%. For bilateral procedures, modifier 50 is paid at 150%. Assistant-at-surgery payment and co-surgeons are permitted; 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 27499 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | Unavailable | $673.72 |
| Beaumont | Unavailable | $632.81 |
| Brazoria | Unavailable | $649.11 |
| Dallas | Unavailable | $655.98 |
| Fort Worth | Unavailable | $653.92 |
| Galveston | Unavailable | $652.83 |
| Houston | Unavailable | $688.71 |
| Rest Of Texas | Unavailable | $642.47 |
How the 27499 rate is calculated
Each of 27499’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 · 27499
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 9.19Practice expense 8.72Malpractice 1.96
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 27499
27499 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 27499
Unlisted procedure
| 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) | 2 | 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 · 27499
Unlisted procedure
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
27499 without 50 · national facility
$663.68
Unlisted procedure
27499-50 · Bilateral: 150%
$995.52
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).
27499 compared with similar codes
Compare codes
27499 vs 27496 vs 27497 vs 27498 vs 27447: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 27496Thigh fasciotomy
- This code is for an unlisted femur or knee operation. Choose 27496 when its specific thigh or knee decompression description accurately captures the procedure.
- 27497Compartment decompression
- Use 27497 when the operation matches its specific decompression description; reserve 27499 for a service without a more specific code.
- 27498Fasciotomy
- Use 27498 when its specific decompression description fits the documented service. Code 27499 is the unlisted option for an operation not captured by a specific code.
- 27447Total knee replacement
- 27447 describes total knee arthroplasty. It is not a substitute for an unlisted femur or knee operation that does not involve that replacement procedure.
27499 billing questions
When should this code be used instead of a decompression code?
Use 27499 when the femur or knee operation is not accurately described by a more specific code. If a dedicated thigh or knee decompression code fits the documented service, report that code instead.
What documentation should accompany the claim?
Include a narrative and operative report identifying the site, condition, technique, and work performed. The documentation should make clear why a more specific code does not describe the service.
Does this code include related postoperative care?
Yes. CMS assigns a 90-day global period, which includes the day-before preoperative visit and 90 days of related postoperative care.
How is this code handled when other procedures are performed in the same session?
The highest-valued procedure is paid in full, and other procedures subject to the standard multiple procedure reduction are paid at 50%.
Can modifier 50 or an assistant-at-surgery service be reported?
For a bilateral procedure, modifier 50 is paid at 150%. Assistant-at-surgery payment is permitted; co-surgeons are permitted, but team surgery is not.
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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