CPT code 27827: Pilon fracture repair, tibia only2026 Medicare rate & RVUs in Missouri
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 doesn’t publish an office rate for 27827 in Missouri.
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 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 in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | Unavailable | $1,022.00 |
| Metropolitan St. Louis, MO | Unavailable | $1,030.61 |
| Rest of Missouri | Unavailable | $985.26 |
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
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
| 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 · 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.
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).
27827 compared with similar codes
Compare codes · National
5 codes, side by side
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.
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
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