Billing code 27050: Joint biopsyMedicare rate & RVUs in Washington
Surgical biopsy of the sacroiliac joint obtains joint tissue for diagnostic evaluation when disease affecting this articulation requires tissue diagnosis.
CMS doesn’t publish an office rate for 27050 in Washington.
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 27050 covers
A surgeon obtains tissue from the sacroiliac joint for diagnostic evaluation, such as when infection, inflammatory disease, or a lesion affecting the joint requires tissue diagnosis. This is a surgical service typically performed by an orthopedic surgeon or another surgeon treating disorders of the pelvis and sacroiliac articulation, usually in an operating room or other surgical setting.
Select this code when the sampled structure is the sacroiliac joint, rather than nearby soft tissue or the hip joint. The operative report should identify the joint and side, describe the biopsy procedure, and support the diagnostic reason for obtaining tissue. This major surgery code includes 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 other procedures are subject to the standard 50% reduction. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery and co-surgeon payment require supporting documentation; 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 27050 pays more and less in Washington
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Washington | Unavailable | $405.07 |
| Seattle (King Cnty) | Unavailable | $449.56 |
How the 27050 rate is calculated
Each of 27050’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 · 27050
RVUs × geographic indexes × conversion factor
Work4.62
4.62 RVUs× 1.000 GPCI
Practice expense6.35
6.35 RVUs× 1.000 GPCI
Malpractice1.00
1.00 RVUs× 1.000 GPCI
Adjusted RVUs
11.9700
Conversion factor
$33.4009
Medicare rate
$399.81
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 27050
27050 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 27050
Joint biopsy
| 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) | 0 | Not paid without supporting documentation. |
| 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 · 27050
Joint biopsy
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
27050 without 50 · national facility
$399.81
Joint biopsy
27050-50 · Bilateral: 150%
$599.72
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).
27050 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 27052Joint biopsy
- Choose 27050 for a sacroiliac joint biopsy and 27052 for a hip joint biopsy. The specific joint sampled determines the code.
- 27040Soft-tissue biopsy
- This code is for biopsy of the sacroiliac joint. Code 27040 applies when the sampled target is superficial soft tissue rather than the joint.
- 27041Soft-tissue biopsy
- This code is for biopsy of the sacroiliac joint. Code 27041 applies when the sampled target is deep soft tissue rather than the joint.
27050 billing questions
How is this distinguished from a biopsy of the hip joint?
Use this code when the sacroiliac joint is the biopsy site. Code 27052 describes biopsy of the hip joint.
Can a nearby soft-tissue biopsy code be used instead?
Use a soft-tissue biopsy code when the sampled target is soft tissue, not the sacroiliac joint itself. The operative note should establish the tissue and site sampled.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and related postoperative care during the 90 days after surgery.
How is bilateral sacroiliac joint biopsy reported?
Report bilateral performance with modifier 50. CMS pays the bilateral procedure at 150%.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment requires documentation of medical necessity. Co-surgeon payment requires supporting documentation, and team surgery is not permitted.
How are other procedures performed in the same session paid?
The highest-valued procedure is paid in full; other procedures in the same session are subject to the standard multiple-procedure reduction.
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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