No office rate
This code represents radical resection of a tibial tumor. Code 27635 is for removal of a lower-leg bone lesion by a different, generally more limited approach.
On this page
CMS RVU26D · Effective 2026-10-01
27645 Tibial tumor resection Medicare reimbursement rates in Vermont
Reports a major operation removing a tibial tumor through radical oncologic resection, typically when the operative plan requires removal of tumor-bearing bone. Compare 27645 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 27645 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
$1491.01
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 27645: Radical tibial tumor resection
Reports a major operation removing a tibial tumor through radical oncologic resection, typically when the operative plan requires removal of tumor-bearing bone.
This code describes an extensive operation to remove a tumor involving the tibia, generally by taking out the tumor-bearing bone as part of an oncologic resection. Orthopedic oncologists typically perform it in a hospital operating room after imaging and biopsy have informed surgical planning. The removed tissue is submitted for pathologic examination. The approach and amount of bone removed depend on the tumor and the planned resection; the diagnosis alone does not determine code selection.
Select this code when the operative report supports radical tumor resection of the tibia, rather than limited curettage, lesion excision, or partial bone removal. Documentation should identify the tibial site, tumor, resection performed, and relevant specimen. Medicare assigns a 90-day global period, including the day-before preoperative visit and related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is paid at 150% for a bilateral procedure. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 27645
- 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 RVU26.53 · 56%
- Practice expense (office) RVU15.41 · 32%
- Malpractice RVU5.64 · 12%
47
Medicare services in 2024 · #5387 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.
27645 compared with similar codes
Office rates for Vermont, from the same CMS release.
No office rate
Code 27640 describes partial excision of the tibia. Choose this code when the documented operation is radical tumor resection, rather than partial tibial removal.
No office rate
Both are radical tumor resections, but 27646 is for the fibula; this code is for the tibia.
No office rate
Code 27647 applies to tumor resection involving the talus or calcaneus, not the tibia.
Compare 27645 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
$1491.01
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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 27645 in Vermont.
PPRRVU2026_Oct_nonQPP.csv
2,989
- Code
- 27645
- Physician work
- 26.53
- Practice expense
- 15.41
- Malpractice
- 5.64
GPCI2026.csv
105
- Locality
- Vermont
- Physician work
- 1.000
- Practice expense
- 0.990
- Malpractice
- 0.506
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 26.53 | × 1.000 | 26.5300 |
| Practice expense | 15.41 | × 0.990 | 15.2559 |
| Malpractice | 5.64 | × 0.506 | 2.8538 |
| Total RVUs | 44.6397 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Vermont$1491.01
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 26.53 | 1 |
| Practice expense | 15.41 | 0.99 |
| Malpractice | 5.64 | 0.506 |
(26.53 × 1 + 15.41 × 0.99 + 5.64 × 0.506) × $33.4009 = $1491.01
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.
27645 billing questions
How is this different from tibial bone-lesion curettage?
Use this code when the operative work is radical oncologic resection of a tibial tumor. A more limited curettage or excision of a bone lesion is represented by a different procedure code.
How does this differ from partial tibial excision?
Code 27640 describes partial removal of the tibia. This code is for radical resection of a tibial tumor, so the operative technique and purpose—not simply the amount of bone removed—guide selection.
What documentation supports reporting this code?
The operative report should identify the tibial tumor and site, describe the radical resection performed, and document the tissue removed. A tumor diagnosis by itself does not establish that the operation was a radical resection.
How are multiple procedures in the same session paid?
The highest-valued procedure is paid in full, and other procedures in the same session are subject to the standard multiple-procedure reduction, with payment at 50%.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be available. 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 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.
2,98627638,,Remove/graft leg bone lesion,A,,10.72,8.26,NA,8.26,,1.94,20.92,20.92,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,98727640,,Partial removal of tibia,A,,11.93,8.90,NA,8.90,,2.18,23.01,23.01,0,090,0.10,0.69,0.21,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,98827641,,Partial removal of fibula,A,,9.59,7.13,NA,7.13,,1.54,18.26,18.26,0,090,0.10,0.69,0.21,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,98927645,,Resect tibia tumor,A,,26.53,15.41,NA,15.41,,5.64,47.58,47.58,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,99027646,,Resect fibula tumor,A,,22.63,14.16,NA,14.16,,4.82,41.61,41.61,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,99127647,,Resect talus/calcaneus tum,A,,19.75,5.73,NA,5.73,,1.68,27.16,27.16,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,99227648,,Injection for ankle x-ray,A,,0.94,5.11,,0.23,,0.14,6.19,1.31,0,000,0.00,0.00,0.00,2,1,0,0,0,9,,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