No office rate
This code addresses the hip capsule. Use 27054 when the surgeon removes synovial tissue lining the hip joint.
On this page
CMS RVU26D · Effective 2026-10-01
27036 Hip capsule surgery Medicare reimbursement rates in Vermont
Reports open release or excision of the hip joint capsule, typically to address capsular contracture or restricted motion, with or without heterotopic bone excision. Compare 27036 office and facility rates across CMS payment localities in Vermont.
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 27036 in Vermont?
Vermont 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
$890.15
1 of 1 localities have a supported rate.
Payment area: Vermont
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 27036: Hip capsular release or excision
Reports open release or excision of the hip joint capsule, typically to address capsular contracture or restricted motion, with or without heterotopic bone excision.
An orthopedic surgeon incises or removes part or all of the hip joint capsule to release restriction or address capsular pathology. The procedure may include excision of heterotopic bone. It is generally performed in an operating room when a hip condition requires operative treatment; the operative report should identify the capsule treated and describe the release or excision performed.
Select this code when the operative work is directed at the hip capsule, rather than at the joint lining, a loose body, or drainage of an infected joint. Document the indication, side, extent of capsular work, and any heterotopic bone excised. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in the same session, the highest-valued procedure is paid in full and other procedures at 50%. Bilateral reporting with modifier 50 is paid at 150%. An assistant at surgery may be paid; co-surgeons are paid only with supporting documentation, and team surgery is not permitted.
CMS billing rules for 27036
- 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 RVU14.02 · 50%
- Practice expense (office) RVU11.24 · 40%
- Malpractice RVU2.97 · 11%
796
Medicare services in 2024 · #3150 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.
27036 compared with similar codes
Office rates for Vermont, from the same CMS release.
No office rate
This code describes capsular release or excision. Use 27033 when the operative objective is hip-joint exploration or removal of a loose or foreign body.
No office rate
This code addresses the hip capsule; 27030 is for hip arthrotomy with drainage.
Compare 27036 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
Vermont →
Office / nonfacility
Unavailable
Facility
$890.15
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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 27036 in Vermont.
PPRRVU2026_Oct_nonQPP.csv
2,719
- Code
- 27036
- Physician work
- 14.02
- Practice expense
- 11.24
- Malpractice
- 2.97
GPCI2026.csv
105
- Locality
- Vermont
- Physician work
- 1.000
- Practice expense
- 0.990
- Malpractice
- 0.506
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 14.02 | × 1.000 | 14.0200 |
| Practice expense | 11.24 | × 0.990 | 11.1276 |
| Malpractice | 2.97 | × 0.506 | 1.5028 |
| Total RVUs | 26.6504 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Vermont$890.15
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 14.02 | 1 |
| Practice expense | 11.24 | 0.99 |
| Malpractice | 2.97 | 0.506 |
(14.02 × 1 + 11.24 × 0.99 + 2.97 × 0.506) × $33.4009 = $890.15
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.
27036 billing questions
When is this code preferable to hip synovectomy?
Use this code when the operative target is the hip capsule and the surgeon releases or excises it. Synovectomy is directed at the joint lining.
Does this code include excision of heterotopic bone?
Capsular surgery may include excision of heterotopic bone. The operative report should show the capsular work and describe any bone excised.
Can a separate loose-body removal code be reported?
Choose the code that reflects the documented operative target and work. This code describes capsular release or excision, while hip arthrotomy for loose-body removal describes a different objective.
How should bilateral hip surgery be reported?
Report bilateral surgery with modifier 50; CMS pays this procedure at 150%.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
May an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeons are paid only with 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 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.
2,71627030,,Arthrotomy hip w/drainage,A,,13.31,9.64,NA,9.64,,2.82,25.77,25.77,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,71727033,,Arthrt hip expl/rmv loose/fb,A,,13.76,10.08,NA,10.08,,2.91,26.75,26.75,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,71827035,,Denervation of hip joint,A,,16.94,13.17,NA,13.17,,0.89,31.00,31.00,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,71927036,,Capsulectomy/capsulotomy hip,A,,14.02,11.24,NA,11.24,,2.97,28.23,28.23,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,72027040,,Biopsy of soft tissues,A,,2.85,6.96,,2.19,,0.43,10.24,5.47,0,010,0.10,0.80,0.10,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,72127041,,Biopsy of soft tissues,A,,9.93,7.67,NA,7.67,,2.01,19.61,19.61,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,72227043,,Exc hip pelvis les sc 3 cm/>,A,,6.71,5.23,NA,5.23,,1.65,13.59,13.59,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
10204412,TX,18,HOUSTON,1.008,0.993,1.376
10304412,TX,99,REST OF TEXAS,1.000,0.949,0.903
10403502,UT,09,UTAH,1.000,0.940,0.898
10514512,VT,50,VERMONT,1.000,0.990,0.506
10611302,VA,00,VIRGINIA,1.000,0.983,0.706
10709202,VI,50,VIRGIN ISLANDS,1.000,1.011,0.985
10802402,WA,02,SEATTLE (KING CNTY),1.050,1.227,0.817