CPT code 27758: Tibia fracture fixation, open, non-intramedullary fixation2026 Medicare rate & RVUs in Maryland
Open surgical fixation of a tibial shaft fracture using a plate, screws, or another non-intramedullary construct, with or without an associated fibular fracture.
CMS doesn’t publish an office rate for 27758 in Maryland.
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 27758 covers
An orthopedic surgeon uses this service to expose and reduce a tibial shaft fracture and stabilize it with a plate, screws, or another non-intramedullary internal fixation construct. The code encompasses treatment of the tibial fracture whether or not a fibular fracture is also present. It is generally performed in an operating room; CMS 2024 claims show facility use for this code. The intramedullary nail approach is distinguished from this service and is reported with a different code.
Select the code from the operative report’s fracture location and fixation method, not simply from the fact that surgery occurred. Documentation should identify the tibial shaft fracture and describe open reduction and the fixation construct. CMS assigns a 90-day global period, including 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. With modifier 50, a bilateral procedure is paid at 150%. Assistant-at-surgery payment may be available; 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 27758 pays more and less in Maryland
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Baltimore area, MD | Unavailable | $884.98 |
| Rest of Maryland | Unavailable | $834.47 |
| Washington, DC area | Unavailable | $925.46 |
How the 27758 rate is calculated
Each of 27758’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 · 27758
RVUs × geographic indexes × conversion factor
Work12.23
12.23 RVUs× 1.000 GPCI
Practice expense10.15
10.15 RVUs× 1.000 GPCI
Malpractice2.57
2.57 RVUs× 1.000 GPCI
Adjusted RVUs
24.9500
Conversion factor
$33.4009
Medicare rate
$833.35
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 27758
27758 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 27758
Tibia fracture fixation, open, non-intramedullary fixation
| 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 · 27758
Tibia fracture fixation, open, non-intramedullary fixation
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
27758 without 50 · national facility
$833.35
Tibia fracture fixation, open, non-intramedullary fixation
27758-50 · Bilateral: 150%
$1,250.03
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).
27758 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 27759Tibial fracture repairIntramedullary implant
- Both address open treatment of a tibial shaft fracture, but 27759 is for intramedullary implant fixation. Use 27758 for plate, screw, or other non-intramedullary fixation.
- 27756Fracture fixationPercutaneous tibial shaft
- 27756 describes percutaneous skeletal fixation; 27758 represents open exposure and fixation with a non-intramedullary construct.
- 27752Tibial fracture careWith manipulation
- 27752 is closed treatment with manipulation. Choose 27758 when the tibial shaft fracture is treated through open surgical reduction and non-intramedullary internal fixation.
27758 billing questions
How does 27758 differ from 27759?
Use 27758 for open tibial shaft fracture fixation with a plate, screws, or another non-intramedullary construct. Use 27759 when fixation is performed with an intramedullary implant.
Can 27758 be reported when the fracture also involves the fibula?
Yes. The tibial shaft fracture treatment represented by 27758 may include an associated fibular fracture.
Is 27758 appropriate for percutaneous fixation?
No. For percutaneous skeletal fixation of a tibial shaft fracture, consider 27756. The approach and fixation documented in the operative report distinguish the services.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How are additional procedures in the same session paid?
The highest-valued procedure is paid in full, while other procedures are subject to the standard multiple procedure reduction. A bilateral procedure reported with modifier 50 is paid at 150%.
What documentation supports assistant or co-surgeon payment?
An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
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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