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Billing code 27756: Fracture fixationMedicare rate & RVUs

Reports percutaneous skeletal fixation of a tibial shaft fracture, with or without an associated fibular fracture, when fixation is performed through a percutaneous approach.

CMS RVU26DEffective Oct 1, 2026109 payment localities49 Medicare services in 2024

Medicare pays $564.48 for 27756 nationally in a facility.

Medicare rate · 27756

Fracture fixation

Swap in your local Medicare rate.

Work RVUs
7.26
Total RVUs
16.90
Global days
090

National rate · 2026

$564.48

Facility setting, before claim adjustments.

See every locality for 27756 → · 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 27756 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 27756 covers

An orthopedic surgeon uses a percutaneous approach to stabilize a fracture through the shaft of the tibia, typically placing fixation devices through small incisions rather than exposing the fracture for open fixation. The code can include an associated fibular fracture; the defining service is skeletal fixation of the tibial shaft fracture. These procedures are generally performed in an operating room, often with imaging guidance to position and assess the fixation.

Select this code when the tibial shaft fracture is treated with percutaneous skeletal fixation. The operative report should establish the fracture site and describe the percutaneous approach and fixation performed. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and others at 50%. Bilateral reporting with modifier 50 is paid at 150%. An assistant at surgery may be paid; co-surgeon payment requires 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 27756 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

27756 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$508.44
Alaska*Unavailable$680.38
ArizonaUnavailable$548.72
ArkansasUnavailable$501.50
AtlantaUnavailable$579.81
AustinUnavailable$574.85
BakersfieldUnavailable$575.11
Baltimore/Surr. CntysUnavailable$600.24
BeaumontUnavailable$536.47
BrazoriaUnavailable$552.73

27756 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
27756 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 27756 rate is calculated

Each of 27756’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 · 27756

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 7.26Practice expense 8.11Malpractice 1.53

16.9000 adjusted RVUs×$33.4009 conversion factor=$564.48

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

Payment rules and modifiers for 27756

27756 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 27756

Fracture fixation

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 · 27756

Fracture fixation

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

27756 without 50 · national facility

$564.48

Fracture fixation

27756-50 · Bilateral: 150%

$846.72

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

27756 compared with similar codes

Compare codes

27756 vs 27750 vs 27752 vs 27758 vs 27759: national Medicare rates

Swap in your local Medicare rate.

  • 27756
    Fracture fixation · 7.26 wRVU
    —
  • 27750
    Tibia fracture care · 3.29 wRVU
    $395.47
  • 27752
    Tibial fracture care · 6.11 wRVU
    $608.23
  • 27758
    Tibia fracture fixation · 12.23 wRVU
    —
  • 27759
    Tibial fracture repair · 14.09 wRVU
    —

How to choose

27750Tibia fracture care
27750 describes closed treatment without manipulation or skeletal fixation. Report 27756 when the tibial shaft fracture receives percutaneous skeletal fixation.
27752Tibial fracture care
27752 is closed treatment with manipulation, without skeletal fixation. Percutaneous skeletal fixation distinguishes 27756.
27758Tibia fracture fixation
27758 involves open treatment with plate-and-screw fixation. Use 27756 for percutaneous skeletal fixation rather than open fracture exposure.
27759Tibial fracture repair
27759 describes treatment using an intramedullary implant. Use 27756 when the tibial shaft fracture is treated with percutaneous skeletal fixation instead.

Codes related to 27756

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

Codes related to 27756
CodeHow it relatesNational office range
Same family
27750Tibia fracture careClosed tibial shaft fracture treatment without manipulation or skeletal fixation.$347.39–$513.20
27752Tibial fracture careClosed tibial shaft fracture treatment with manipulation, without skeletal fixation.$535.85–$768.76
27758Tibia fracture fixationOpen tibial shaft fracture treatment using plate-and-screw fixation.No office rate
27759Tibial fracture repairTibial shaft fracture treatment using an intramedullary implant.No office rate

27756 billing questions

How does this differ from closed treatment codes 27750 and 27752?

Use 27756 when skeletal fixation is performed percutaneously. Codes 27750 and 27752 describe closed treatment without skeletal fixation, distinguished by whether manipulation is performed.

When should 27758 or 27759 be reported instead?

Choose 27758 for open tibial shaft fracture treatment using plate-and-screw fixation, and 27759 when treatment uses an intramedullary implant. The operative approach and fixation method distinguish these services from percutaneous skeletal fixation.

Does an associated fibular fracture change the code?

The tibial shaft fixation service may include an associated fibular fracture. Documentation should identify the tibial shaft fracture and the percutaneous fixation performed.

Are routine postoperative visits included?

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

How does Medicare handle multiple procedures or bilateral reporting?

For multiple procedures in the same session, the highest-valued procedure is paid in full and the others at 50%. Bilateral reporting with modifier 50 is paid 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 27756PPRRVU2026_Oct_nonQPP.csv, line 3,038 (RVU26D)

Open CMS sourceHow we calculate rates

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