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CPT code 27827: Pilon fracture repair, tibia only2026 Medicare rate & RVUs

Reports open treatment of a distal tibial plafond fracture when the surgeon repairs the tibia without treating the fibula as part of the procedure.

CMS RVU26DEffective Oct 1, 2026109 payment localities1.5K Medicare services in 2024

Medicare pays $1,053.13 for 27827 nationally in a facility.

Medicare rate · 27827

Pilon fracture repair, tibia only

Office or facility?

Work RVUs
14.42
Total RVUs
31.53
Global days
090

National rate · 2026

$1,053.13

Facility setting, before claim adjustments.

See every locality for 27827 →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 27827 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 27827 covers

This code covers open treatment of a pilon fracture involving the weight-bearing articular surface at the distal tibia. The surgeon exposes and reduces the fracture and may use internal fixation; fixation is included in the procedure. Orthopedic trauma surgeons typically perform the operation in a hospital operating room, often for a displaced fracture extending into the ankle joint after high-energy trauma.

Choose this code when the operative report supports treatment of the tibial plafond alone. When the procedure treats both the tibia and fibula, use the corresponding combined code, 27828. Documentation should identify the fracture site and describe the reduction and fixation performed. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care. In a same-session multiple-procedure claim, the highest-valued procedure is paid in full and other procedures are subject to the standard 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 27827 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

27827 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$951.35
AlaskaUnavailable$1,280.62
ArizonaUnavailable$1,024.32
ArkansasUnavailable$938.77
Atlanta, GAUnavailable$1,081.89
Austin, TXUnavailable$1,070.35
Bakersfield, CAUnavailable$1,069.32
Baltimore area, MDUnavailable$1,118.66
Beaumont, TXUnavailable$1,003.56
Brazoria, TXUnavailable$1,031.12

27827 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.

View every state and territory as a table
27827 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 27827 rate is calculated

Each of 27827’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 · 27827

RVUs × geographic indexes × conversion factor

Office or facility?

Work14.42

14.42 RVUs× 1.000 GPCI

Practice expense14.17

14.17 RVUs× 1.000 GPCI

Malpractice2.94

2.94 RVUs× 1.000 GPCI

Adjusted RVUs

31.5300

Conversion factor

$33.4009

Medicare rate

$1,053.13

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

Payment rules and modifiers for 27827

27827 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 27827

Pilon fracture repair, tibia only

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 · 27827

Pilon fracture repair, tibia only

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

27827 without 50 · national facility

$1,053.13

Pilon fracture repair, tibia only

27827-50 · Bilateral: 150%

$1,579.70

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

27827 compared with similar codes

Compare codes · National

5 codes, side by side

Office or facility?

  • 27827

    Pilon fracture repair, tibia only14.42 wRVU

    Not priced

  • 27828

    Pilon fracture repair, with fibular fixation17.97 wRVU

    Not priced

  • 27826

    Fracture repair, posterior malleolus10.82 wRVU

    Not priced

  • 27822

    Ankle fracture surgery, without posterior lip fixation10.93 wRVU

    Not priced

  • 27823

    Ankle fracture repair, posterior lip fixation12.83 wRVU

    Not priced

How to choose

27828Pilon fracture repairWith fibular fixation
Both address pilon fractures, but 27828 applies when treatment includes both the distal tibia and fibula; 27827 is for tibial treatment alone.
27826Fracture repairPosterior malleolus
This code is for open treatment of a distal fibular fracture. Choose 27827 for open treatment of the tibial plafond.
27822Ankle fracture surgeryWithout posterior lip fixation
27822 describes open treatment of a trimalleolar ankle fracture without fixation of the posterior lip; 27827 addresses a tibial plafond fracture.
27823Ankle fracture repairPosterior lip fixation
27823 describes open treatment of a trimalleolar ankle fracture with fixation of the posterior lip; 27827 addresses a tibial plafond fracture.

Codes related to 27827

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

Codes related to 27827
CodeHow it relatesNational office range
Same family
27828Pilon fracture repair, with fibular fixationPilon fracture treatment when the operation includes both the tibia and fibula.No office rate
Used instead
27826Fracture repair, posterior malleolusOpen treatment for an isolated distal fibular fracture rather than a tibial plafond fracture.No office rate
27822Ankle fracture surgery, without posterior lip fixationOpen treatment for a trimalleolar ankle fracture without fixation of the posterior lip.No office rate
27823Ankle fracture repair, posterior lip fixationOpen treatment for a trimalleolar ankle fracture with fixation of the posterior lip.No office rate

27827 billing questions

When should 27827 be chosen instead of 27828?

Use 27827 when the operation treats the tibial plafond alone. Use 27828 when the surgeon treats both the tibia and fibula as part of the pilon fracture procedure.

Is internal fixation separately reported?

Internal fixation performed as part of the open fracture treatment is included in 27827. The operative report should support the fracture reduction and the fixation performed.

Does this code have a global period?

Yes. The 90-day global period includes the day-before preoperative visit and related postoperative care for 90 days.

How does Medicare handle other procedures in the same session?

Under the standard multiple-procedure reduction, Medicare pays the highest-valued procedure in full and reduces payment for the other procedures.

Can an assistant or co-surgeon be reported?

Assistant-at-surgery payment may be made, and co-surgeons are permitted. Team surgery is not permitted.

How is bilateral treatment handled?

When the procedure is bilateral and reported with modifier 50, CMS pays it at 150%.

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 27827PPRRVU2026_Oct_nonQPP.csv, line 3,063 (RVU26D)

Open CMS sourceHow we calculate rates

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