CPT code 27280: SI joint fusion, open, grafted, instrumented2026 Medicare rate & RVUs in Texas
Report this code for open fusion of the sacroiliac joint using bone graft and instrumentation, rather than a percutaneous or minimally invasive approach.
CMS doesn’t publish an office rate for 27280 in Texas.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 sections
What 27280 covers
This service is an open operation to fuse the sacroiliac joint. The surgeon exposes the joint, prepares the opposing surfaces for fusion, places bone graft, and uses instrumentation to support the construct. It is commonly performed by an orthopedic or spine surgeon in a hospital operating room for a patient undergoing surgical treatment of sacroiliac joint disease or instability.
Select this code when the operative report supports an open approach with graft and instrumentation; distinguish it from percutaneous or minimally invasive SI joint fusion codes based on the documented technique and implant placement. Documentation should identify the treated side, approach, joint preparation, graft use, and instrumentation. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in the same session, the highest-valued procedure is paid in full and others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be made; 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 27280 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin, TX | Unavailable | $1,286.87 |
| Beaumont, TX | Unavailable | $1,230.52 |
| Brazoria, TX | Unavailable | $1,240.55 |
| Dallas, TX | Unavailable | $1,259.09 |
| Fort Worth, TX | Unavailable | $1,257.41 |
| Galveston, TX | Unavailable | $1,251.09 |
| Houston, TX | Unavailable | $1,361.65 |
| Rest of Texas | Unavailable | $1,242.07 |
How the 27280 rate is calculated
Each of 27280’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 · 27280
RVUs × geographic indexes × conversion factor
Work19.50
19.50 RVUs× 1.000 GPCI
Practice expense12.89
12.89 RVUs× 1.000 GPCI
Malpractice6.04
6.04 RVUs× 1.000 GPCI
Adjusted RVUs
38.4300
Conversion factor
$33.4009
Medicare rate
$1,283.60
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 27280
27280 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 27280
SI joint fusion, open, grafted, instrumented
| 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) | 2 | Paid. |
| 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 · 27280
SI joint fusion, open, grafted, instrumented
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
27280 without 50 · national facility
$1,283.60
SI joint fusion, open, grafted, instrumented
27280-50 · Bilateral: 150%
$1,925.40
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).
27280 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 27278SI joint fusionIntra-articular implants
- This code describes open fusion with graft and instrumentation. Code 27278 is for percutaneous or minimally invasive fusion with intra-articular implant placement.
- 27279SI joint fusionTransarticular device placement
- Choose this code for the open, grafted procedure. Code 27279 describes percutaneous or minimally invasive fusion using a transfixing device.
- 27299Unlisted pelvis/hip procedureCarrier priced
- Code 27299 is for an unlisted pelvis or hip joint procedure when no specific code describes the service; ordinary open SI joint fusion is specifically described by this code.
27280 billing questions
How does this code differ from percutaneous SI joint fusion codes?
Use this code for an open operation with bone graft and instrumentation. Codes 27278 and 27279 describe percutaneous or minimally invasive approaches distinguished by implant placement.
What operative details support reporting this code?
Document the open approach, the SI joint treated, preparation of the joint surfaces, bone graft use, and placement of instrumentation.
Can both sides be reported?
For a bilateral procedure, report modifier 50; CMS pays the bilateral procedure at 150%.
Does the global period include routine postoperative care?
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 may be made. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
How are other procedures in the same session paid?
CMS pays the highest-valued procedure in full and other procedures at 50% under 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
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