CPT code 27759: Tibial fracture repair, intramedullary implant2026 Medicare rate & RVUs in Texas
Report this procedure when a surgeon treats a tibial shaft fracture operatively using an intramedullary implant, with or without interlocking screws or cerclage.
CMS doesn’t publish an office rate for 27759 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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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 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 | $928.03 |
| Beaumont, TX | Unavailable | $879.79 |
| Brazoria, TX | Unavailable | $897.00 |
| Dallas, TX | Unavailable | $906.95 |
| Fort Worth, TX | Unavailable | $904.75 |
| Galveston, TX | Unavailable | $902.45 |
| Houston, TX | Unavailable | $956.82 |
| Rest of Texas | Unavailable | $890.80 |
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
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
| 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) | 2 | Permitted. |
| 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 · 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.
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).
27759 compared with similar codes
Compare codes · National
5 codes, side by side
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.
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
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