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Billing code 29851: Knee fracture repairMedicare rate & RVUs

Reports arthroscopically assisted operative repair of a knee intercondylar spine or tuberosity fracture when fixation or repair is performed.

CMS RVU26DEffective Oct 1, 2026109 payment localities18 Medicare services in 2024

Medicare pays $861.74 for 29851 nationally in a facility.

Medicare rate · 29851

Knee fracture repair

Swap in your local Medicare rate.

Work RVUs
12.93
Total RVUs
25.80
Global days
090

National rate · 2026

$861.74

Facility setting, before claim adjustments.

See every locality for 29851 → · 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 29851 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 29851 covers

Orthopedic surgeons use 29851 for arthroscopically assisted operative treatment of a fracture involving the knee’s intercondylar spine, also called the tibial eminence, and/or tibial tuberosity, when fixation or repair is performed. A familiar example is arthroscopic reduction and fixation of a displaced tibial spine avulsion. The service is typically performed in a hospital operating room or ambulatory surgery center; it is distinct from a diagnostic-only knee scope and from treatment of a tibial plateau fracture.

Report the service for the treated knee, supported by documentation of the fracture site and the arthroscopic reduction, fixation, or repair performed. Diagnostic arthroscopy of that knee is integral to the operative service. CMS 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 others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment and co-surgeons are permitted; team surgery is not.

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 29851 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

29851 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$779.63
Alaska*Unavailable$1,058.41
ArizonaUnavailable$838.04
ArkansasUnavailable$769.53
AtlantaUnavailable$886.91
AustinUnavailable$871.74
BakersfieldUnavailable$866.48
Baltimore/Surr. CntysUnavailable$915.10
BeaumontUnavailable$824.80
BrazoriaUnavailable$841.95

29851 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
29851 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 29851 rate is calculated

Each of 29851’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 · 29851

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 12.93Practice expense 10.12Malpractice 2.75

25.8000 adjusted RVUs×$33.4009 conversion factor=$861.74

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

Payment rules and modifiers for 29851

29851 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 29851

Knee 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 · 29851

Knee 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

29851 without 50 · national facility

$861.74

Knee fracture repair

29851-50 · Bilateral: 150%

$1,292.61

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

29851 compared with similar codes

Compare codes

29851 vs 29850 vs 29855 vs 29856 vs 27535: national Medicare rates

Swap in your local Medicare rate.

  • 29851
    Knee fracture repair · 12.93 wRVU
    —
  • 29850
    Knee arthroscopy · 8.06 wRVU
    —
  • 29855
    Tibial fracture repair · 10.49 wRVU
    —
  • 29856
    Knee fracture repair · 13.92 wRVU
    —
  • 27535
    Tibial plateau fracture · 13.07 wRVU
    —

How to choose

29850Knee arthroscopy
Choose 29851 when fixation or repair is performed for the spine or tuberosity fracture; 29850 is for treatment without internal fixation.
29855Tibial fracture repair
29855 addresses an arthroscopically treated unicondylar proximal tibial plateau fracture, rather than a knee spine or tuberosity fracture.
29856Knee fracture repair
29856 is for arthroscopically aided treatment of a bicondylar proximal tibial plateau fracture.
27535Tibial plateau fracture
Use 27535 for open treatment of a unicondylar proximal tibial plateau fracture; 29851 is arthroscopically assisted treatment of a spine or tuberosity fracture.

Codes related to 29851

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

Codes related to 29851
CodeHow it relatesNational office range
Same family
29850Knee arthroscopyArthroscopic treatment of the same fracture locations without internal fixation.No office rate
Used instead
29855Tibial fracture repairArthroscopically aided treatment for a unicondylar proximal tibial plateau fracture.No office rate
29856Knee fracture repairArthroscopically aided treatment for a bicondylar proximal tibial plateau fracture.No office rate
27535Tibial plateau fractureOpen treatment option for a unicondylar proximal tibial plateau fracture.No office rate
27536Tibial plateau repairOpen treatment option for a bicondylar proximal tibial plateau fracture.No office rate

29851 billing questions

How does 29851 differ from 29850?

Use 29851 when the arthroscopically assisted fracture treatment includes internal fixation or repair. Code 29850 describes the corresponding treatment without internal fixation.

Can diagnostic knee arthroscopy be billed separately?

Diagnostic arthroscopy of the same knee is integral to the operative fracture treatment and is not separately reported for that service.

Is the code reported per fracture fragment or per knee?

Report the operative service for the treated knee; the number of fragments or fixation devices does not create additional units.

What documentation supports 29851?

Document the fracture location and the arthroscopically assisted reduction, fixation, or repair performed. The record should distinguish a spine or tuberosity fracture from a tibial plateau fracture.

Can modifier 50 be used for bilateral treatment?

CMS identifies this as a bilateral procedure; 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 29851PPRRVU2026_Oct_nonQPP.csv, line 3,343 (RVU26D)

Open CMS sourceHow we calculate rates

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