Billing code 29855: Tibial fracture repairMedicare rate & RVUs in Delaware
Report this code when an orthopedic surgeon uses arthroscopy to treat a fracture of one tibial plateau condyle, including internal fixation when performed.
CMS doesn’t publish an office rate for 29855 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 29855 covers
This code describes arthroscopically assisted operative treatment of a fracture involving one condyle of the proximal tibia, at the knee joint. An orthopedic surgeon typically performs the procedure in a hospital or ambulatory surgical setting, using arthroscopic visualization to assist fracture treatment. Internal fixation is included when performed. The code is specific to a unicondylar tibial plateau fracture; the number of condyles treated distinguishes it from the corresponding bicondylar arthroscopic service.
Report the service for the fracture treatment, not for diagnostic knee arthroscopy alone. The operative report should identify the fracture site and unicondylar involvement and describe the arthroscopic assistance and any fixation. Medicare assigns a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When multiple procedures occur 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%. Assistant-at-surgery payment may be made, 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.
29855 in Delaware
| Payment locality | Office | Facility |
|---|---|---|
| Delaware | Unavailable | $720.59 |
How the 29855 rate is calculated
Each of 29855’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 · 29855
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 10.49Practice expense 9.20Malpractice 2.16
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 29855
29855 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 29855
Tibial fracture repair
| 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 · 29855
Tibial 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.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
29855 without 50 · national facility
$729.81
Tibial fracture repair
29855-50 · Bilateral: 150%
$1,094.72
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).
29855 compared with similar codes
Compare codes
29855 vs 29856 vs 27535 vs 27530: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 29856Knee fracture repair
- Both describe arthroscopically assisted tibial plateau fracture treatment; choose 29855 for unicondylar involvement and 29856 for bicondylar involvement.
- 27535Tibial plateau fracture
- This code is for arthroscopically assisted treatment of a unicondylar fracture; 27535 describes open treatment of a unicondylar proximal tibial plateau fracture.
- 27530Fracture treatment
- Use 29855 for arthroscopically assisted operative fracture treatment. Code 27530 is a closed-treatment option for a proximal tibial plateau fracture.
29855 billing questions
How do I distinguish this code from 29856?
Use this code for arthroscopically assisted treatment of a unicondylar tibial plateau fracture. Code 29856 describes the bicondylar counterpart.
Is internal fixation included?
Yes. Internal fixation is included when performed as part of the arthroscopically assisted fracture treatment.
Can I report a diagnostic knee arthroscopy separately?
When arthroscopy is used to assist the fracture treatment, report the fracture-treatment service rather than a separate diagnostic arthroscopy for that same operative work.
What documentation supports this code?
Document the proximal tibial plateau fracture, that one condyle is involved, and how arthroscopy assisted treatment. Include fixation details when fixation was performed.
How does Medicare handle multiple procedures in the same session?
The highest-valued procedure is paid in full, with other procedures paid at 50%. The code has a 90-day global period that includes related postoperative care.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be made, and co-surgeons are permitted. 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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