Billing code 27781: Fibula fracture careMedicare rate & RVUs in Alaska
Physicians report 27781 when they manipulate a proximal fibular or shaft fracture and continue nonoperative care without opening the fracture site.
Medicare pays $571.68 for 27781 in the office in Alaska (Alaska*). Which amount applies depends on the service address.
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 9 sections
What 27781 covers
Code 27781 represents closed management of a fracture in the proximal fibula or fibular shaft when the clinician performs a manipulation to improve alignment. An orthopedic surgeon typically provides the reduction and directs immobilization and follow-up, often in a hospital, emergency department, or office setting. The fracture is managed without surgically opening the site; a cast or other immobilization may be part of the care.
Report the code when the documented fracture location and treatment support manipulation, rather than immobilization alone. The record should identify the fracture site and describe the reduction maneuver and subsequent treatment. CMS assigns a 90-day global period, which includes the day-before preoperative visit and 90 days of 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 treatment with modifier 50 is paid at 150%. Assistant-at-surgery services are not paid, and co-surgeons and team surgery are 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.
27781 in Alaska*
| Payment locality | Office | Facility |
|---|---|---|
| Alaska* | $571.68 | $483.46 |
How the 27781 rate is calculated
Each of 27781’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 · 27781
RVUs × geographic indexes × conversion factor
Work4.48
4.48 RVUs× 1.000 GPCI
Practice expense9.28
9.28 RVUs× 1.000 GPCI
Malpractice0.93
0.93 RVUs× 1.000 GPCI
Adjusted RVUs
14.6900
Conversion factor
$33.4009
Medicare rate
$490.66
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 27781
27781 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 27781
Fibula fracture care
| 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) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not 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 · 27781
Fibula fracture care
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
27781 without 50 · national office
$490.66
Fibula fracture care
27781-50 · Bilateral: 150%
$735.99
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).
27781 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 27780Fibula fracture care
- Both address a proximal fibula or shaft fracture. Choose 27781 when manipulation is performed; choose 27780 when treatment is without manipulation.
- 27784Fibula fracture
- 27781 describes closed treatment with manipulation. 27784 is the open-treatment option for a proximal fibula or shaft fracture.
- 27788Ankle fracture care
- Both involve manipulation, but 27788 is for a distal fibular fracture; 27781 is for the proximal fibula or shaft.
27781 billing questions
How does 27781 differ from 27780?
27781 is for a proximal fibula or shaft fracture treated with manipulation. Use 27780 when the same fracture location is treated without manipulation.
Does placing a cast qualify as manipulation?
No. The record should support a reduction maneuver to improve fracture alignment; immobilization alone points to treatment without manipulation.
When should 27784 be considered instead?
27784 describes open treatment of a proximal fibula or shaft fracture. It is the relevant comparison when the fracture site is surgically opened for treatment.
Can 27781 be reported for a distal fibula fracture?
No. This code is for the proximal fibula or shaft. Distal fibular fractures are represented by codes such as 27786 or 27788, depending on whether manipulation is performed.
How is bilateral treatment reported?
For bilateral treatment, report modifier 50; CMS lists payment at 150% for the bilateral procedure.
What follow-up care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
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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