Billing code 27535: Tibial plateau fractureMedicare rate & RVUs in Delaware
Open operative treatment of a unicondylar proximal tibial plateau fracture, with internal fixation included when performed, is reported for the affected knee.
CMS doesn’t publish an office rate for 27535 in Delaware.
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 27535 covers
This service covers operative treatment of a fracture involving one condyle of the proximal tibial plateau. An orthopedic surgeon typically performs it in an operating room, exposing and treating the fracture; internal fixation is included when used. It is distinct from surgery for a bicondylar plateau fracture and from treatment of tibial spine or tuberosity fractures.
Report the code when the operative record supports open treatment and identifies the fracture as unicondylar. Document the affected side, fracture anatomy, operative approach, and fixation performed. CMS assigns a 90-day global period, including 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 and co-surgeon services may be paid; 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.
27535 in Delaware
| Payment locality | Office | Facility |
|---|---|---|
| Delaware | Unavailable | $804.78 |
How the 27535 rate is calculated
Each of 27535’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 · 27535
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 13.07Practice expense 8.59Malpractice 2.75
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 27535
27535 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 27535
Tibial plateau fracture
| 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) | 2 | Paid. |
| Co-surgeons (62) | 2 | 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 · 27535
Tibial plateau fracture
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
27535 without 50 · national facility
$815.32
Tibial plateau fracture
27535-50 · Bilateral: 150%
$1,222.98
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).
27535 compared with similar codes
Compare codes
27535 vs 27536 vs 27530 vs 27532 vs 27540: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 27536Tibial plateau repair
- Choose 27535 for a unicondylar plateau fracture treated operatively; 27536 describes operative treatment of a bicondylar plateau fracture.
- 27530Fracture treatment
- 27530 is for closed treatment of a proximal tibial plateau fracture without manipulation. This code is for open operative treatment.
- 27532Fracture treatment
- 27532 describes closed treatment of a proximal tibial plateau fracture with manipulation; it is not the open operative service represented here.
- 27540Knee fracture repair
- 27540 concerns operative treatment of a tibial spine or knee tuberosity fracture. This code is for a unicondylar proximal tibial plateau fracture.
27535 billing questions
How is this code distinguished from 27536?
This code is for open treatment of a unicondylar tibial plateau fracture. Use 27536 when the plateau fracture is bicondylar.
Can internal fixation be billed separately?
Internal fixation, when performed as part of this fracture treatment, is included in the service. The operative report should describe the fixation and fracture treatment.
How does this differ from 27530 or 27532?
Those codes describe closed treatment of a proximal tibial plateau fracture. This code applies when the fracture is treated operatively through an open approach.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How are additional procedures in the same session paid?
The highest-valued procedure is paid in full; other procedures are subject to the standard multiple-procedure reduction, with payment at 50%.
May an assistant or co-surgeon be reported?
CMS permits payment for an assistant at surgery and for co-surgeons. Team surgery is not permitted for this code.
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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