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Billing code 27727: Lower-leg repairMedicare rate & RVUs

Reports operative repair of a tibial and fibular nonunion or malunion when an intramedullary rod is inserted as part of the reconstruction.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare pays $957.94 for 27727 nationally in a facility.

Medicare rate · 27727

Lower-leg repair

Swap in your local Medicare rate.

Work RVUs
14.47
Total RVUs
28.68
Global days
090

National rate · 2026

$957.94

Facility setting, before claim adjustments.

See every locality for 27727 → · 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.

On this page 10 sections
  1. Medicare rate
  2. What 27727 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 27727 covers

This service addresses a tibial and fibular fracture that has failed to unite or healed in a position requiring operative correction. The surgeon repairs both lower-leg bones and inserts an intramedullary rod as part of the reconstruction. It is typically performed by an orthopedic surgeon in a hospital or ambulatory surgical setting; the operative report should identify the affected bones, the nonunion or malunion, and the rod insertion.

Select this code when the repair involves both the tibia and fibula and includes intramedullary rod insertion; a tibia-only repair or fibula-only repair points to a different code. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same 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 may be available; co-surgeons require supporting documentation, and 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 27727 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

27727 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$867.03
Alaska*Unavailable$1,177.91
ArizonaUnavailable$931.68
ArkansasUnavailable$855.86
AtlantaUnavailable$985.89
AustinUnavailable$968.85
BakersfieldUnavailable$962.91
Baltimore/Surr. CntysUnavailable$1,017.08
BeaumontUnavailable$917.16
BrazoriaUnavailable$935.97

27727 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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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
27727 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 27727 rate is calculated

Each of 27727’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 · 27727

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 14.47Practice expense 11.15Malpractice 3.06

28.6800 adjusted RVUs×$33.4009 conversion factor=$957.94

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 27727

27727 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 27727

Lower-leg repair

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)1Permitted with supporting documentation.
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 · 27727

Lower-leg repair

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.

  • 24 Unrelated E/M visit by the same physician
  • 79 Unrelated procedure (starts its own global period)
  • 58 Staged, more extensive, or therapy procedure that was planned
  • 78 Unplanned 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

27727 without 50 · national facility

$957.94

Lower-leg repair

27727-50 · Bilateral: 150%

$1,436.91

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

27727 compared with similar codes

Compare codes

27727 vs 27725 vs 27726 vs 27724: national Medicare rates

Swap in your local Medicare rate.

  • 27727
    Lower-leg repair · 14.47 wRVU
    —
  • 27725
    Tibial nonunion repair · 16.97 wRVU
    —
  • 27726
    Fibula repair · 13.98 wRVU
    —
  • 27724
    Tibia repair · 18.83 wRVU
    —

How to choose

27725Tibial nonunion repair
Use 27725 when the repair with intramedullary rod insertion is limited to the tibia. This code is for repair involving both the tibia and fibula.
27726Fibula repair
Use 27726 for a fibula-only nonunion or malunion repair. This code involves both lower-leg bones and includes rod insertion.
27724Tibia repair
27724 applies to a tibia-only repair using iliac or other autograft. This code describes repair of both the tibia and fibula with rod insertion.

Codes related to 27727

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

Codes related to 27727
CodeHow it relatesNational office range
Same family
27725Tibial nonunion repairRod-assisted nonunion or malunion repair limited to the tibia.No office rate
27726Fibula repairNonunion or malunion repair limited to the fibula.No office rate
Used instead
27720Tibia repairTibia-only nonunion or malunion repair without the rod-insertion approach.No office rate
27724Tibia repairTibia-only repair using an iliac or other autograft approach.No office rate

27727 billing questions

When should I choose this code instead of 27725?

Use this code when the nonunion or malunion repair involves both the tibia and fibula and includes intramedullary rod insertion. Code 27725 describes a tibia-only repair with rod insertion.

Is the intramedullary rod part of the service?

Yes. Rod insertion is part of the repair described by this code; document it in the operative report.

Can this code be reported bilaterally?

For bilateral procedures, CMS payment is 150% when modifier 50 is used. Document the service on both sides.

How does the multiple-procedure reduction affect payment?

For procedures performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to a 50% reduction.

What documentation supports reporting this code?

The operative report should establish nonunion or malunion involving both the tibia and fibula and describe the repair and intramedullary rod insertion.

Can an assistant or co-surgeon be reported?

Assistant-at-surgery payment may be available. Co-surgeons are paid only with supporting documentation; team surgery is 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 27727PPRRVU2026_Oct_nonQPP.csv, line 3,029 (RVU26D)

Open CMS sourceHow we calculate rates

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