CPT code 27824: Fracture treatment, distal tibia, no manipulation2026 Medicare rate & RVUs in Texas
Reports closed care of a distal tibial fracture, such as a pilon fracture, when the fracture is treated without manipulation or reduction.
Medicare pays $334.74–$367.64 for 27824 in the office in Texas, from Beaumont, TX to Austin, TX. Which amount applies depends on the service address.
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 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.
Where 27824 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 payment localities
$334.74 to $367.64
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin, TX | $367.64 | $326.29 |
| Beaumont, TX | $334.74 | $299.18 |
| Brazoria, TX | $350.76 | $312.04 |
| Dallas, TX | $353.70 | $314.78 |
| Fort Worth, TX | $351.71 | $313.18 |
| Galveston, TX | $352.26 | $313.46 |
| Houston, TX | $364.16 | $325.35 |
| Rest of Texas | $343.03 | $305.95 |
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
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.
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
| 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) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not 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 · 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.
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).
27824 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 27825Fracture treatmentDistal tibia, with manipulation
- Both describe closed treatment of a distal tibial fracture. Choose 27824 when no manipulation is performed and 27825 when the physician manipulates the fracture.
- 27826Fracture repairPosterior malleolus
- 27824 is closed treatment without manipulation; 27826 is for open treatment of a distal tibial fracture.
- 27827Pilon fracture repairTibia only
- 27824 describes closed treatment without manipulation. 27827 describes open treatment with internal fixation of the tibia only.
- 27828Pilon fracture repairWith fibular fixation
- 27824 describes closed treatment without manipulation. 27828 describes open treatment with internal fixation of both the tibia and fibula.
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
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