Billing code 27358: Femur lesionMedicare rate & RVUs in Washington
Add-on reporting for internal fixation performed with curettage or excision of a femoral bone lesion when stabilization is part of treatment.
CMS doesn’t publish an office rate for 27358 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 27358 covers
This add-on captures internal fixation performed with operative treatment of a femoral bone lesion, such as curettage or excision of a benign lesion when the bone needs stabilization. An orthopedic surgeon typically performs the work in an operating room, placing fixation as part of the same operative treatment. The fixation supports the treated segment; this code is not a stand-alone report for fixation unrelated to femoral lesion removal.
Report 27358 with the applicable primary femoral lesion procedure, such as 27355, when the operative record supports both lesion treatment and internal fixation. Documentation should identify the femoral lesion, describe the curettage or excision, and establish that fixation was performed as part of the treatment. CMS classifies the code as an add-on: it must be billed with a primary procedure, and payment falls within that procedure’s global period.
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 27358 pays more and less in Washington
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Washington | Unavailable | $233.10 |
| Seattle (King Cnty) | Unavailable | $249.21 |
How the 27358 rate is calculated
Each of 27358’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 · 27358
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 4.61Practice expense 1.47Malpractice 1.00
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 27358
The CMS indicators that decide how 27358 is paid alongside other services.
CMS payment indicators · 27358
Femur lesion
| Rule | CMS value | What it means |
|---|---|---|
| Global period | ZZZ | Add-on code: falls within the primary procedure’s global period. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 80 · payment effect
With and without the modifier
27358 without 80 · national facility
$236.48
Femur lesion
27358-80 · Assistant: 16%
$37.84
A physician assistant at surgery is paid 16% of the surgeon’s fee schedule amount.
27358 compared with similar codes
Compare codes
27358 vs 27355 vs 27356 vs 27365: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 27355Femur lesion removal
- 27355 reports the primary femoral lesion treatment. Add 27358 only when internal fixation is also performed as part of that treatment.
- 27356Bone lesion surgery
- 27356 is a related femoral lesion procedure variant involving grafting; 27358 captures fixation as an add-on to the primary procedure.
- 27365Bone tumor resection
- 27365 describes resection of a femoral or knee tumor. 27358 is for fixation accompanying the applicable femoral lesion procedure, not tumor resection by itself.
27358 billing questions
Can 27358 be billed by itself?
No. It is an add-on code and must be reported with the applicable primary procedure for femoral lesion treatment.
When is 27358 appropriate with 27355?
Report it when the femoral lesion procedure includes internal fixation. The operative note should support both lesion treatment and fixation.
Does lesion removal alone support 27358?
No. The add-on represents fixation performed with the lesion procedure; lesion removal without fixation does not support it.
What documentation supports the fixation add-on?
Document the femoral lesion procedure and the internal fixation performed as part of that treatment. The code is paid within the primary procedure’s global period.
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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