CPT code 27635: Bone lesion removal2026 Medicare rate & RVUs in Virginia
Reported for operative excision or curettage of a cyst or benign tumor in the tibia or fibula when the procedure does not include bone grafting.
CMS doesn’t publish an office rate for 27635 in Virginia.
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 27635 covers
An orthopedic surgeon or orthopedic oncologist uses this procedure to remove or curette a bone cyst or benign tumor in the tibia or fibula. The surgeon exposes the affected bone and removes the lesion, typically in an operating room. The removed tissue may be submitted for pathology. The code distinguishes this treatment of a lower-leg bone lesion from removal of a soft-tissue mass or a more extensive bone resection.
Select this code when the documented procedure treats a tibial or fibular cyst or benign tumor without the grafting described by the related graft-specific codes. The operative report should identify the bone and lesion, describe the excision or curettage, and document whether a graft was used. 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 are subject to the standard 50% reduction. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment is restricted; co-surgeon payment requires supporting documentation, and 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 27635 pays more and less in Virginia
| Payment locality | Office | Facility |
|---|---|---|
| Dc + Md/Va Suburbs | Unavailable | $607.47 |
| Virginia | Unavailable | $528.08 |
How the 27635 rate is calculated
Each of 27635’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 · 27635
RVUs × geographic indexes × conversion factor
Work7.83
7.83 RVUs× 1.000 GPCI
Practice expense7.12
7.12 RVUs× 1.000 GPCI
Malpractice1.39
1.39 RVUs× 1.000 GPCI
Adjusted RVUs
16.3400
Conversion factor
$33.4009
Medicare rate
$545.77
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 27635
27635 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 27635
Bone lesion removal
| 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) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| 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 · 27635
Bone lesion removal
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
27635 without 50 · national facility
$545.77
Bone lesion removal
27635-50 · Bilateral: 150%
$818.66
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).
27635 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 27637Bone lesion grafting
- Use 27635 for tibial or fibular cyst or benign-tumor removal without the grafting represented by 27637; the graft-specific procedure belongs to 27637.
- 27638Bone lesion surgery
- 27638 is the related graft-specific option for allografting. 27635 describes lesion removal or curettage without that grafting.
- 27640Tibial bone excision
- 27640 describes partial removal of the tibia, rather than curettage or excision of a cyst or benign tumor.
- 27645Tibial tumor resection
- 27645 is for tibial tumor resection; 27635 describes excision or curettage of a bone cyst or benign tumor.
27635 billing questions
How does this differ from 27637 or 27638?
27635 is for tibial or fibular lesion removal without the grafting represented by those related codes. Choose the applicable graft-specific code when the operative service includes that grafting.
Can I report this for a biopsy alone?
No. A diagnostic biopsy that samples lower-leg soft tissue is a different service; 27635 describes operative removal or curettage of a bone cyst or benign tumor.
What should the operative note support?
Document whether the lesion was in the tibia or fibula, its cystic or benign-tumor diagnosis, the removal or curettage performed, and whether grafting was part of the procedure.
How is bilateral treatment reported?
CMS lists this as a bilateral procedure; modifier 50 is paid at 150%. The documentation should support treatment of both sides.
Does the surgeon's postoperative care fall within the global period?
Yes. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be paid?
Assistant-at-surgery payment is subject to a statutory restriction and is not 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 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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