Partial excision of bone from the femur, proximal tibia, and/or fibula — performed for osteomyelitis, bone abscess, or similar infectious or destructive conditions — using craterization, saucerization, or diaphysectomy technique.

Verified May 8, 2026 · 7 sources ↓

Medicare: $856.73
Total RVUs: 25.65
Global, days: 90
Region: Knee

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Documentation requirements

What must appear in the operative or office note to support the claim.

Source · Editorial brief grounded in 7 cited references ↓

Specify which bone(s) were addressed: femur, proximal tibia, and/or fibula — not just 'leg bone'
Name the surgical technique used: craterization, saucerization, or diaphysectomy
Document the clinical indication (e.g., osteomyelitis, bone abscess) with corresponding ICD-10 diagnosis code
Describe extent of bone removed and condition of surrounding tissue, especially if modifier 22 is appended
Include intraoperative findings confirming presence of infectious or necrotic bone tissue
Record whether cultures or pathology specimens were sent, as this supports the infectious/destructive diagnosis

Applicable modifiers

Modifiers commonly billed with this code.

Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual

22 Increased complexity 24 Unrelated E/M during global 25 Significant separate E/M 51 Multiple procedures 58 Staged or related 59 Distinct service 76 Repeat, same physician 77 Repeat, another physician 78 Unplanned return — related 79 Unrelated during global LT Left side RT Right side

What this code covers

Source · Editorial summary grounded in 7 cited references ↓

CPT 27360 covers partial bone excision at the femur, proximal tibia, and/or fibula when the goal is to remove infected, necrotic, or otherwise diseased bone tissue. The procedure descriptor includes craterization, saucerization, and diaphysectomy as acceptable surgical techniques. The 'and/or' language in the descriptor is intentional: 27360 is correctly reported whether the surgeon addresses one bone (e.g., proximal tibia only) or any combination of the three bones in a single operative session.

The primary clinical drivers are osteomyelitis and bone abscess, though destructive lesions requiring the same technique may also apply. This is a high-complexity surgical procedure with a 90-day global period, meaning all routine post-operative management through day 90 is bundled into the reimbursement. Separate E&M services during the global window require modifier 24 (unrelated) or modifier 25 (significant, separately identifiable, same day as a minor procedure decision).

Billers should be attentive to NCCI bundling edits when 27360 is reported alongside other musculoskeletal codes on the same date. Local anesthesia is not separately reportable. Radiologic guidance is not separately billable unless documentation clearly supports a distinct additional procedure. When the work required is substantially greater than typical — for example, extensive debridement across multiple bony surfaces or severe infectious involvement — modifier 22 with supporting operative note documentation is appropriate.

RVU & reimbursement

Component RVUs and Medicare national rate. Actual payment varies by GPCI locality.

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU	11.17
Practice expense RVU	12.1
Malpractice RVU	2.38
Total RVU	25.65
Medicare national rate	$856.73
Global period	90 days

Payment by site of service

Medicare pays different rates by setting. HOPD typically pays substantially more than ASC for the same procedure.

Source · CMS OPPS Addendum B·ASC HCPCS payment rates·2026

Setting	Medicare rate (national)
Office (PFS non-facility) Procedure performed in physician's office	$856.73
HOPD (APC 5113) Hospital outpatient department	$3,342.87
ASC (PI A2) Ambulatory surgical center (freestanding)	$1,644.87

Common denial reasons

The recurring reasons claims for CPT 27360 get rejected.

Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓

Diagnosis mismatch — billing 27360 with a tumor or cyst ICD-10 code when 27355–27357 range is more appropriate
Bundling denial when local anesthesia or routine fluoroscopy is billed separately on the same date
Missing or vague operative note — 'partial excision performed' without naming technique or specific bone(s)
Modifier 22 appended without supporting documentation quantifying the increased complexity or time
Global period violation — post-op E&M billed within 90 days without modifier 24 or 25 to establish unrelated or separately identifiable service

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 7 cited references ↓

01Can 27360 be billed if only the proximal tibia was treated, not the femur?

Yes. The 'and/or' language in the descriptor means 27360 is reportable for the femur, proximal tibia, or fibula individually, or any combination. You don't need to address all three bones to use this code.

02What's the global period for 27360 and what does it include?

27360 carries a 90-day global period. That covers the surgery, the day-before visit, and all routine post-op visits through day 90. Bill modifier 24 for unrelated E&M services during that window, or modifier 25 if a significant separately identifiable E&M occurs on the same day as a related minor procedure.

03Is modifier 22 ever appropriate for 27360?

Yes, when the procedure required substantially more work than typical — extensive multi-surface debridement, severe infectious involvement, or significantly prolonged operative time. The operative note must quantify the added complexity; a generic statement won't survive audit.

04How does 27360 differ from 27355 or 27357?

27355–27357 are for excision or curettage of bone cysts and benign tumors of the femur. 27360 is for infectious or destructive conditions — osteomyelitis and bone abscess are the named examples. Diagnosis-to-code alignment is the key audit risk if you use 27360 with a tumor ICD-10 code.

05Can fluoroscopy or imaging guidance be billed separately with 27360?

Only if a distinct additional procedure on the same date independently warrants imaging guidance. Routine intraoperative fluoroscopy to guide the partial excision itself is not separately reportable under NCCI guidelines.

06Is 27360 reportable bilaterally, and how is that coded?

If the procedure is performed on both legs in the same session, append modifier 50 and bill on a single line per Medicare convention. Verify individual payer preference — some commercial payers require two lines with LT and RT instead.

Sources & references

Editorial content was developed using the following public sources. Last verified May 8, 2026.

Mira AI Scribe

Mira's AI scribe captures the operative technique name (craterization, saucerization, or diaphysectomy), the specific bone(s) addressed, and the intraoperative findings describing the infected or necrotic tissue. It also flags when the note mentions increased complexity — such as multi-surface involvement or prolonged debridement — so modifier 22 documentation is in place before the claim is submitted. This prevents the most common audit flag: a vague operative note that names the procedure without identifying technique or anatomic site.

See how Mira captures CPT 27360 documentation