No office rate
27355 reports the primary femoral lesion treatment. Add 27358 only when internal fixation is also performed as part of that treatment.
On this page
CMS RVU26D · Effective 2026-10-01
27358 Femur lesion Medicare reimbursement rates in Wyoming
Add-on reporting for internal fixation performed with curettage or excision of a femoral bone lesion when stabilization is part of treatment. Compare 27358 office and facility rates across CMS payment localities in Wyoming.
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 27358 in Wyoming?
Wyoming 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
$227.79
1 of 1 localities have a supported rate.
Payment area: Wyoming**
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 27358: Femoral lesion removal with fixation
Add-on reporting for internal fixation performed with curettage or excision of a femoral bone lesion when stabilization is part of treatment.
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.
CMS billing rules for 27358
- Global period
- Add-on code: billed only together with a primary procedure and paid within that procedure's global period.
Where the value comes from
- Work RVU4.61 · 65%
- Practice expense (office) RVU1.47 · 21%
- Malpractice RVU1.00 · 14%
22
Medicare services in 2024 · #5860 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.
27358 compared with similar codes
Office rates for Wyoming, from the same CMS release.
No office rate
27356 is a related femoral lesion procedure variant involving grafting; 27358 captures fixation as an add-on to the primary procedure.
No office rate
27365 describes resection of a femoral or knee tumor. 27358 is for fixation accompanying the applicable femoral lesion procedure, not tumor resection by itself.
Compare 27358 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
Wyoming** →
Office / nonfacility
Unavailable
Facility
$227.79
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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 27358 in Wyoming**.
PPRRVU2026_Oct_nonQPP.csv
2,856
- Code
- 27358
- Physician work
- 4.61
- Practice expense
- 1.47
- Malpractice
- 1.00
GPCI2026.csv
112
- Locality
- Wyoming**
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.740
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 4.61 | × 1.000 | 4.6100 |
| Practice expense | 1.47 | × 1.000 | 1.4700 |
| Malpractice | 1.00 | × 0.740 | 0.7400 |
| Total RVUs | 6.8200 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Wyoming**$227.79
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 4.61 | 1 |
| Practice expense | 1.47 | 1 |
| Malpractice | 1 | 0.74 |
(4.61 × 1 + 1.47 × 1 + 1 × 0.74) × $33.4009 = $227.79
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.
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 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.
2,85327355,,Remove femur lesion,A,,7.80,7.85,NA,7.85,,1.64,17.29,17.29,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,85427356,,Remove femur lesion/graft,A,,9.84,8.93,NA,8.93,,2.09,20.86,20.86,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,85527357,,Remove femur lesion/graft,A,,10.88,9.76,NA,9.76,,2.31,22.95,22.95,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,85627358,,Remove femur lesion/fixation,A,,4.61,1.47,NA,1.47,,1.00,7.08,7.08,0,ZZZ,0.00,0.00,0.00,0,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,85727360,,Partial removal leg bone(s),A,,11.17,12.10,NA,12.10,,2.38,25.65,25.65,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,85827364,,Resect thigh/knee tum 5 cm/>,A,,23.88,13.61,NA,13.61,,5.34,42.83,42.83,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,85927365,,Resect femur/knee tumor,A,,31.40,16.89,NA,16.89,,6.71,55.00,55.00,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
10902402,WA,99,REST OF WASHINGTON,1.013,1.053,0.761
11011402,WV,16,WEST VIRGINIA,1.000,0.869,1.431
11106302,WI,00,WISCONSIN,1.000,0.958,0.308
11203602,WY,21,WYOMING**,1.000,1.000,0.740
113"MAC Assignments as of November 22, 2023",,,,,,
114,,,,,,
115*Work GPCI reflects a 1.5 floor in Alaska established by the MIPPA.,,,,,,