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CPT code 27759: Tibial fracture repair, intramedullary implant2026 Medicare rate & RVUs

Report this procedure when a surgeon treats a tibial shaft fracture operatively using an intramedullary implant, with or without interlocking screws or cerclage.

CMS RVU26DEffective Oct 1, 2026109 payment localities5.6K Medicare services in 2024

Medicare pays $918.19 for 27759 nationally in a facility.

Medicare rate · 27759

Tibial fracture repair, intramedullary implant

Office or facility?

Work RVUs
14.09
Total RVUs
27.49
Global days
090

National rate · 2026

$918.19

Facility setting, before claim adjustments.

See every locality for 27759 →Billed by an NP, PA or therapist? →

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

Your location

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What 27759 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 27759 covers

An orthopedic surgeon uses an intramedullary implant, typically a nail placed within the tibial canal, to stabilize a tibial shaft fracture. Interlocking screws or cerclage may also be used. The service is commonly performed in an operating room for fractures requiring operative stabilization; the code distinguishes this approach from closed fracture treatment and percutaneous skeletal fixation. The fracture site need not necessarily be directly exposed for the operative treatment to qualify.

Report 27759 when the operative record supports treatment of a tibial shaft fracture with intramedullary fixation. Document the fracture location, the implant and fixation method, and any additional fixation used. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment and co-surgeons are permitted; 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 27759 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

27759 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$831.59
AlaskaUnavailable$1,131.60
ArizonaUnavailable$893.11
ArkansasUnavailable$820.96
Atlanta, GAUnavailable$945.12
Austin, TXUnavailable$928.03
Bakersfield, CAUnavailable$921.79
Baltimore area, MDUnavailable$974.66
Beaumont, TXUnavailable$879.79
Brazoria, TXUnavailable$897.00

27759 rates by state

Office rate range in each state. Select a state to see its payment localities.

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Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

View every state and territory as a table
27759 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 27759 rate is calculated

Each of 27759’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 · 27759

RVUs × geographic indexes × conversion factor

Office or facility?

Work14.09

14.09 RVUs× 1.000 GPCI

Practice expense10.43

10.43 RVUs× 1.000 GPCI

Malpractice2.97

2.97 RVUs× 1.000 GPCI

Adjusted RVUs

27.4900

Conversion factor

$33.4009

Medicare rate

$918.19

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 27759

27759 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 27759

Tibial fracture repair, intramedullary implant

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
Assistant at surgery (80/81/82/AS)2Paid.
Co-surgeons (62)2Permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.69/0.21Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 27759

Tibial fracture repair, intramedullary implant

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.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 50 · payment effect

With and without the modifier

27759 without 50 · national facility

$918.19

Tibial fracture repair, intramedullary implant

27759-50 · Bilateral: 150%

$1,377.29

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).

When to use modifier 50

27759 compared with similar codes

Compare codes · National

5 codes, side by side

Office or facility?

  • 27759

    Tibial fracture repair, intramedullary implant14.09 wRVU

    Not priced

  • 27758

    Tibia fracture fixation, open, non-intramedullary fixation12.23 wRVU

    Not priced

  • 27756

    Fracture fixation, percutaneous tibial shaft7.26 wRVU

    Not priced

  • 27752

    Tibial fracture care, with manipulation6.11 wRVU

    $608.23

  • 27750

    Tibia fracture care, without manipulation3.29 wRVU

    $395.47

How to choose

27758Tibia fracture fixationOpen, non-intramedullary fixation
Choose 27759 when the tibial shaft fracture is stabilized with an intramedullary implant; choose 27758 for fixation using a plate and screws.
27756Fracture fixationPercutaneous tibial shaft
27756 describes percutaneous skeletal fixation of the tibial shaft fracture. 27759 is the intramedullary implant treatment code.
27752Tibial fracture careWith manipulation
27752 is closed treatment with manipulation, with or without skeletal traction. It does not describe operative intramedullary fixation.
27750Tibia fracture careWithout manipulation
27750 is closed tibial shaft fracture treatment without manipulation; 27759 is operative treatment using an intramedullary implant.

Codes related to 27759

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 27759
CodeHow it relatesNational office range
Same family
27758Tibia fracture fixation, open, non-intramedullary fixationTibial shaft fracture fixation using a plate-and-screw construct rather than an intramedullary implant.No office rate
Used instead
27756Fracture fixation, percutaneous tibial shaftPercutaneous skeletal fixation for a tibial shaft fracture instead of intramedullary implant treatment.No office rate
27752Tibial fracture care, with manipulationClosed tibial shaft fracture treatment with manipulation, with or without skeletal traction.$535.85–$768.76
27750Tibia fracture care, without manipulationClosed tibial shaft fracture treatment without manipulation.$347.39–$513.20

27759 billing questions

How is 27759 different from 27758?

27759 is for operative tibial shaft fracture treatment using an intramedullary implant. 27758 is the related option when fixation uses a plate and screws rather than an intramedullary implant.

When would 27756 be more appropriate?

Use 27756 for percutaneous skeletal fixation of a tibial shaft fracture. 27759 describes operative treatment using an intramedullary implant.

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.

How is bilateral treatment reported?

For bilateral tibial shaft fractures treated in the same session, report modifier 50; CMS pays the bilateral procedure at 150%.

Can an assistant or co-surgeon be paid?

CMS permits assistant-at-surgery payment and co-surgeons for this code. Team surgery is not permitted.

What operative documentation supports 27759?

Document that the fracture is in the tibial shaft and describe intramedullary implant fixation, including any interlocking screws or cerclage used.

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
RVUs for 27759PPRRVU2026_Oct_nonQPP.csv, line 3,040 (RVU26D)

Open CMS sourceHow we calculate rates

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