FeeBase
Log inGet started
Menu

Billing code 27828: Pilon fracture repairMedicare rate & RVUs

Open fixation of a distal tibial pilon fracture with fibular fixation, reported when operative treatment addresses both the tibial plafond injury and fibula.

CMS RVU26DEffective Oct 1, 2026109 payment localities1.6K Medicare services in 2024

Medicare pays $1,230.16 for 27828 nationally in a facility.

Medicare rate · 27828

Pilon fracture repair

Swap in your local Medicare rate.

Work RVUs
17.97
Total RVUs
36.83
Global days
090

National rate · 2026

$1,230.16

Facility setting, before claim adjustments.

See every locality for 27828 → · 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 27828 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 27828 covers

An orthopedic surgeon typically reports this service for open operative treatment of a distal tibial pilon or tibial plafond fracture when the fibula is also fixed. These injuries often require hospital operating-room care, particularly when the fracture involves the weight-bearing surface of the ankle. The code accounts for internal fixation of the tibia and, when performed, fixation of the fibula as part of the pilon fracture treatment.

Select this code when the operative report supports open treatment of the distal tibial fracture and documents fibular fixation; use the related pilon code 27827 when fibular fixation is not performed. Documentation should identify the fracture sites, open approach, and fixation performed. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. In a same-session multiple-procedure setting, the highest-valued procedure is paid in full and other procedures at 50%. 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 27828 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

27828 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$1,113.84
Alaska*Unavailable$1,508.72
ArizonaUnavailable$1,196.89
ArkansasUnavailable$1,099.51
AtlantaUnavailable$1,264.53
AustinUnavailable$1,246.98
BakersfieldUnavailable$1,242.82
Baltimore/Surr. CntysUnavailable$1,305.68
BeaumontUnavailable$1,175.77
BrazoriaUnavailable$1,203.63

27828 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
27828 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 27828 rate is calculated

Each of 27828’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 · 27828

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 17.97Practice expense 15.22Malpractice 3.64

36.8300 adjusted RVUs×$33.4009 conversion factor=$1,230.16

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

Payment rules and modifiers for 27828

27828 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 27828

Pilon fracture 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)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 · 27828

Pilon fracture 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

27828 without 50 · national facility

$1,230.16

Pilon fracture repair

27828-50 · Bilateral: 150%

$1,845.24

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

27828 compared with similar codes

Compare codes

27828 vs 27827 vs 27826 vs 27829 vs 27822: national Medicare rates

Swap in your local Medicare rate.

  • 27828
    Pilon fracture repair · 17.97 wRVU
    —
  • 27827
    Pilon fracture repair · 14.42 wRVU
    —
  • 27826
    Fracture repair · 10.82 wRVU
    —
  • 27829
    Syndesmosis repair · 8.58 wRVU
    —
  • 27822
    Ankle fracture surgery · 10.93 wRVU
    —

How to choose

27827Pilon fracture repair
Use 27827 for open pilon fracture treatment without fibular fixation. When the fibula is fixed as part of the treatment, 27828 is the distinguishing code.
27826Fracture repair
27826 describes open treatment of a distal fibular fracture. It does not describe the combined pilon fracture treatment with fibular fixation represented by 27828.
27829Syndesmosis repair
27829 addresses open treatment of a distal tibiofibular syndesmosis disruption. Choose based on the operative condition treated, rather than treating syndesmosis repair as pilon fracture fixation.
27822Ankle fracture surgery
27822 is for open treatment of a trimalleolar ankle fracture without fixation of the posterior lip. It is not the pilon fracture code for distal tibial plafond involvement with fibular fixation.

Codes related to 27828

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

Codes related to 27828
CodeHow it relatesNational office range
Same family
27827Pilon fracture repairOpen pilon fracture treatment when fibular fixation is not performed.No office rate
Used instead
27826Fracture repairOpen treatment for an isolated distal fibular fracture rather than a pilon fracture with fibular fixation.No office rate
27824Fracture treatmentClosed treatment of a distal tibial fracture without manipulation.$314.17–$458.90
27825Fracture treatmentClosed treatment of a distal tibial fracture with manipulation.$534.22–$758.13

27828 billing questions

How does 27828 differ from 27827?

Both apply to open treatment of a distal tibial pilon or plafond fracture. Use 27828 when the fibula is also fixed; 27827 applies when fibular fixation is not performed.

Can the internal fixation be reported separately?

No separate fixation service is represented by this code; internal fixation is included in the pilon fracture treatment.

What should the operative report document?

Document the distal tibial pilon or plafond fracture, the open treatment, and the fibular fixation performed. The report should make clear that the fibular work occurred as part of the fracture treatment.

What is included in the global period?

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

How does Medicare handle another procedure performed in the same session?

The highest-valued procedure is paid in full, and other procedures are paid at 50%. Bilateral reporting with modifier 50 is paid at 150%.

May an assistant or co-surgeon be reported?

Assistant-at-surgery payment and co-surgeons are permitted for this code. 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 27828PPRRVU2026_Oct_nonQPP.csv, line 3,064 (RVU26D)

Open CMS sourceHow we calculate rates

Did this answer your question about what 27828 pays?

Tell us what you were actually trying to work out. We’ll answer you directly, or build the page that does.

Fee sheets

Put 27828 and the rest of your codes on one sheet

Build a fee sheet from your own code list at your locality, put your payer contracts beside Medicare, and see what changed each quarter.

Build my fee sheetOr price your code list free →