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CPT code 27824: Fracture treatment, distal tibia, no manipulation2026 Medicare rate & RVUs in North Carolina

Reports closed care of a distal tibial fracture, such as a pilon fracture, when the fracture is treated without manipulation or reduction.

CMS RVU26DEffective Oct 1, 2026One payment locality504 Medicare services in 2024

In North Carolina, Medicare pays $333.67 for 27824 in the office and $297.21 when it’s performed in a hospital or facility.

$333.67Office (non-facility)
$297.21Hospital or facility
−6.5%vs the national office rate ($356.72)

Check a contract rate as a % of Medicare · 27824 nationwide

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

We’ll open 27824 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in North Carolina
  2. What 27824 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 27824 covers

An orthopedic surgeon or other qualified physician reports this service for closed treatment of a fracture at the lower end of the tibia, including a pilon or tibial plafond fracture. The fracture is managed without manipulating the fragments to restore alignment. Treatment may include immobilization, such as a cast or splint, in an office, emergency, or hospital setting. This code is for the distal tibia, not a fracture limited to an ankle malleolus.

Select the code based on the fracture site and whether the physician manipulated the fracture or treated it through an open approach. The record should identify the distal tibial fracture and support closed treatment without manipulation. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures at 50%. For bilateral treatment reported with modifier 50, CMS pays at 150%. Assistant-at-surgery payment is restricted; co-surgeons and team surgery are 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.

How North Carolina compares for 27824

Across 109 of 109 payment localities, the office rate for 27824 runs from $314.17 in Arkansas to $458.90 in San Benito County, CA. North Carolina pays $333.67. The RVUs are the same everywhere; the geographic indexes change the dollars.

27824 in North Carolina vs other payment areas
  1. North Carolina · this page$333.67
  2. Los Angeles, CA · California$395.41+$61.74
  3. Washington, DC area · District of Columbia$405.43+$71.76
  4. Miami, FL · Florida$399.23+$65.56
  5. Chicago, IL · Illinois$386.73+$53.06
  6. Manhattan, NY · New York$413.14+$79.47
  7. Alaska · Alaska$415.68+$82.01

Other areas in North Carolina first, then benchmark localities. Bars start at $0.

Every other payment area

27824 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$318.91$284.71
ArkansasArkansas$314.17$280.60
ArizonaArizona$346.55$308.69
Bakersfield, CACalifornia$372.09$329.26
Chico, CACalifornia$370.29$327.46
El Centro, CACalifornia$370.39$327.56
Fresno, CACalifornia$370.29$327.46
Hanford, CACalifornia$370.29$327.46

27824 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

Local rates. Clear comparisons.

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

$314.17

$415.68

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
27824 office rate range by state
State / territoryOffice rate rangeLocalities
AK$415.681
AL$318.911
AR$314.171
AZ$346.551
CA$370.29–$458.9029
CO$367.801
CT$380.931
DC$405.431
DE$352.341
FL$357.65–$399.233
GA$336.36–$365.042
GU$378.701
HI$378.701
IA$324.321
ID$327.111
IL$349.18–$386.734
IN$328.981
KS$324.151
KY$329.671
LA$329.69–$346.272
MA$366.08–$402.822
MD$358.75–$405.433
ME$330.34–$346.672
MI$339.76–$363.672
MN$348.021
MO$324.81–$345.863
MS$319.481
MT$356.681
NC$333.671
ND$343.831
NE$325.731
NH$363.321
NJ$384.04–$401.332
NM$342.231
NV$353.321
NY$338.92–$425.165
OH$337.141
OK$327.581
OR$349.37–$378.102
PA$336.90–$372.172
PR$358.891
RI$363.921
SC$336.201
SD$342.311
TN$326.001
TX$334.74–$367.648
UT$340.881
VA$346.48–$405.432
VI$358.891
VT$343.731
WA$364.97–$409.702
WI$332.161
WV$336.331
WY$351.081

See 27824 in every payment locality

How the 27824 rate is calculated

Each of 27824’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 · 27824

RVUs × geographic indexes × conversion factor

Office or facility?

Work3.23

3.23 RVUs× 1.000 GPCI

Practice expense6.80

6.80 RVUs× 1.000 GPCI

Malpractice0.65

0.65 RVUs× 1.000 GPCI

Adjusted RVUs

10.6800

Conversion factor

$33.4009

Medicare rate

$356.72

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

The exact North Carolina inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

3,060

Code
27824
Physician work
3.23
Practice expense
6.80
Malpractice
0.65

GPCI2026.csv

83

Locality
North Carolina
Physician work
1.000
Practice expense
0.933
Malpractice
0.639
Office calculation for 27824 in North Carolina
ComponentRVULocality factorAdjusted
Physician work3.23× 1.0003.2300
Practice expense6.80× 0.9336.3444
Malpractice0.65× 0.6390.4153
Total RVUs9.9898
Conversion factor× 33.4009

Office rate, North Carolina$333.67

Office: (3.23 × 1 + 6.8 × 0.933 + 0.65 × 0.639) × $33.4009 = $333.67

Facility: (3.23 × 1 + 5.63 × 0.933 + 0.65 × 0.639) × $33.4009 = $297.21

Open 27824 in the RVU calculator

Payment rules and modifiers for 27824

27824 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 27824

Fracture treatment, distal tibia, no manipulation

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)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
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 · 27824

Fracture treatment, distal tibia, no manipulation

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

27824 without 50 · national office

$356.72

Fracture treatment, distal tibia, no manipulation

27824-50 · Bilateral: 150%

$535.08

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

Codes related to 27824

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

Codes related to 27824
CodeHow it relatesOffice range, North Carolina
Same family
27825Fracture treatment, distal tibia, with manipulationClosed treatment of a distal tibial fracture when manipulation is performed.$565.07
Used instead
27826Fracture repair, posterior malleolusOpen treatment of a distal tibial fracture rather than closed treatment without manipulation.No office rate
27827Pilon fracture repair, tibia onlyOpen distal tibial fracture treatment with internal fixation of the tibia only.No office rate
27828Pilon fracture repair, with fibular fixationOpen distal tibial fracture treatment with internal fixation of the tibia and fibula.No office rate

How 27824 has changed in North Carolina

27824 · Office / nonfacility

$333.67

Effective 2026-10-01

The base rate is $33.03 higher than on 2025-10-01, moving from $300.64 to $333.67 (11.0%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    $300.64changed to$333.67

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 3.31 changed to 3.23
    • Practice expense RVU 6.01 changed to 6.80
    • Malpractice RVU 0.63 changed to 0.65
    • Practice expense GPCI 0.926 changed to 0.933
    • Malpractice GPCI 0.665 changed to 0.639

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $306.47changed to$300.64

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 5.93 changed to 6.01
    • Malpractice RVU 0.61 changed to 0.63

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $301.47changed to$306.47

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $311.02changed to$301.47

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 5.85 changed to 5.93
    • Malpractice RVU 0.60 changed to 0.61
    • Practice expense GPCI 0.927 changed to 0.926
    • Malpractice GPCI 0.742 changed to 0.665

  5. January 1, 2023

    RVU23A

    $312.64changed to$311.02

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 5.63 changed to 5.85
    • Malpractice RVU 0.61 changed to 0.60
    • Practice expense GPCI 0.928 changed to 0.927
    • Malpractice GPCI 0.819 changed to 0.742

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $312.93changed to$312.64

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 5.55 changed to 5.63
    • Malpractice RVU 0.62 changed to 0.61

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $310.38changed to$312.93

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 5.20 changed to 5.55
    • Malpractice RVU 0.60 changed to 0.62
    • Practice expense GPCI 0.930 changed to 0.928
    • Malpractice GPCI 0.757 changed to 0.819

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $305.94changed to$310.38

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 5.13 changed to 5.20
    • Malpractice RVU 0.58 changed to 0.60
    • Practice expense GPCI 0.931 changed to 0.930
    • Malpractice GPCI 0.695 changed to 0.757

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $305.19changed to$305.94

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 5.11 changed to 5.13
    • Malpractice RVU 0.59 changed to 0.58

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $302.69changed to$305.19

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 5.04 changed to 5.11
    • Malpractice GPCI 0.732 changed to 0.695

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $302.83changed to$302.69

    • Conversion factor 35.8043 changed to 35.8887
    • Malpractice RVU 0.60 changed to 0.59
    • Practice expense GPCI 0.930 changed to 0.931
    • Malpractice GPCI 0.768 changed to 0.732

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $302.98changed to$302.83

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 5.02 changed to 5.04
    • Malpractice RVU 0.59 changed to 0.60

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $301.47changed to$302.98

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $300.51changed to$301.47

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 5.01 changed to 5.02
    • Malpractice RVU 0.58 changed to 0.59
    • Practice expense GPCI 0.929 changed to 0.930
    • Malpractice GPCI 0.732 changed to 0.768

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $299.88changed to$300.51

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 5.48 changed to 5.01
    • Malpractice RVU 0.61 changed to 0.58
    • Practice expense GPCI 0.927 changed to 0.929
    • Malpractice GPCI 0.695 changed to 0.732

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $299.88

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$333.67$297.21RVU26D
2026-07-01$333.67$297.21RVU26C
2026-04-01$333.67$297.21RVU26B
2026-01-01$333.67$297.21RVU26A
2025-10-01$300.64$291.35RVU25D
2025-07-01$300.64$291.35RVU25C
2025-04-01$300.64$291.35RVU25B
2025-01-01$300.64$291.35RVU25A
2024-10-01$306.47$295.99RVU24D
2024-07-01$306.47$295.99RVU24C
2024-04-01$306.47$295.99RVU24B
2024-03-09$306.47$295.99RVU24AR
2024-01-01$301.47$291.16RVU24A
2023-10-01$311.02$299.08RVU23D
2023-07-01$311.02$299.08RVU23C
2023-04-01$311.02$299.08RVU23B
2023-01-01$311.02$299.08RVU23A
2022-10-01$312.64$299.79RVU22D
2022-07-01$312.64$299.79RVU22C
2022-04-01$312.64$299.79RVU22B
2022-01-01$312.64$299.79RVU22A
2021-10-01$312.93$299.98RVU21D
2021-07-01$312.93$299.98RVU21C
2021-04-01$312.93$299.98RVU21B
2021-01-01$312.93$299.98RVU21A
2020-10-01$310.38$298.29RVU20D
2020-07-01$310.38$298.29RVU20C
2020-04-01$310.38$298.29RVU20B
2020-01-01$310.38$298.29RVU20A
2019-10-01$305.94$295.54RVU19D
2019-07-01$305.94$295.54RVU19C
2019-04-01$305.94$295.54RVU19B
2019-01-01$305.94$295.54RVU19A
2018-10-01$305.19$295.80RVU18D
2018-07-01$305.19$295.80RVU18C
2018-04-01$305.19$295.80RVU18B
2018-01-01$305.19$295.80RVU18AR1
2017-10-01$302.69$294.34RVU17D
2017-07-01$302.69$294.34RVU17C
2017-04-01$302.69$294.34RVU17B
2017-01-01$302.69$294.34RVU17A
2016-10-01$302.83$294.51RVU16D
2016-07-01$302.83$294.51RVU16C
2016-04-01$302.83$294.51RVU16B
2016-01-01$302.83$294.51RVU16A
2015-10-01$302.98$294.29RVU15D
2015-07-01$302.98$294.29RVU15C
2015-04-01$301.47$292.83RVU15B
2015-01-01$301.47$292.83RVU15A
2014-10-01$300.51$292.53RVU14D
2014-07-01$300.51$292.53RVU14C
2014-04-01$300.51$292.53RVU14B
2014-01-01$300.51$292.53RVU14A
2013-10-01$299.88$291.36RVU13D
2013-07-01$299.88$291.36RVU13C
2013-04-01$299.88$291.36RVU13B
2013-01-01$299.88$291.36RVU13AR

Price 27824 for an earlier date of service

Where the North Carolina rate applies

North Carolina is a Medicare payment area, not a city. Our Census mapping connects it to 785 cities and communities in North Carolina. Some span more than one payment area; confirm with the service ZIP.

  • Aberdeen
  • Advance
  • Ahoskie
  • Alamance
  • Albemarle
  • Alexis
  • Alliance
  • Altamahaw

Browse all communities in North Carolina

27824 billing questions

When should 27824 be selected instead of 27825?

Use 27824 when a distal tibial fracture is treated closed without manipulation. Use 27825 when the physician manipulates the fracture.

How does 27824 differ from the open-treatment codes?

27824 describes closed treatment without manipulation. When the physician treats the distal tibial fracture through an open approach, select the applicable open-treatment code, such as 27826, 27827, or 27828, based on the documented procedure.

Are the cast or splint and follow-up visits separately reported?

Immobilization may be part of the fracture treatment. The 90-day global period includes related postoperative care, so routine follow-up during that period is included.

Can 27824 be reported for both legs?

For bilateral treatment, report modifier 50; CMS pays bilateral procedures at 150% under this code's payment rule.

Can an assistant or co-surgeon be paid for this procedure?

CMS does not pay an assistant at surgery for this code. Co-surgeons and team surgery are 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

Show the CMS file lines behind this rate
RVUs for 27824PPRRVU2026_Oct_nonQPP.csv, line 3,060 (RVU26D)
Geographic factors for North CarolinaGPCI2026.csv, line 83 (RVU26D)

Open CMS sourceHow we calculate rates

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