Billing code 27759: Tibial fracture repairMedicare rate & RVUs in Florida

Report this procedure when a surgeon treats a tibial shaft fracture operatively using an intramedullary implant, with or without interlocking screws or cerclage.

CMS RVU26DEffective Oct 1, 20263 payment localities5.6K Medicare services in 2024

CMS doesn’t publish an office rate for 27759 in Florida.

—Office (non-facility)
$952.76–$1,084.15Hospital or facility

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 27759 for the payment locality that covers the ZIP.

On this page 9 sections
  1. Rate in Florida
  2. What 27759 covers
  3. By payment locality
  4. How it’s calculated
  5. Payment rules
  6. Similar codes
  7. Related codes
  8. Billing questions
  9. Sources

What 27759 covers

An orthopedic surgeon uses an intramedullary implant, typically a nail placed within the tibial canal, to stabilize a tibial shaft fracture. Interlocking screws or cerclage may also be used. The service is commonly performed in an operating room for fractures requiring operative stabilization; the code distinguishes this approach from closed fracture treatment and percutaneous skeletal fixation. The fracture site need not necessarily be directly exposed for the operative treatment to qualify.

Report 27759 when the operative record supports treatment of a tibial shaft fracture with intramedullary fixation. Document the fracture location, the implant and fixation method, and any additional fixation used. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one 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 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 27759 pays more and less in Florida

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

27759 office and facility rates by payment locality
Payment localityOfficeFacility
Fort LauderdaleUnavailable$1,002.87
MiamiUnavailable$1,084.15
Rest Of FloridaUnavailable$952.76

How the 27759 rate is calculated

Each of 27759’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 · 27759

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 14.09Practice expense 10.43Malpractice 2.97

27.4900 adjusted RVUs×$33.4009 conversion factor=$918.19

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

Payment rules and modifiers for 27759

27759 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 27759

Tibial 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 · 27759

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.

  • 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

27759 without 50 · national facility

$918.19

Tibial fracture repair

27759-50 · Bilateral: 150%

$1,377.29

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

27759 compared with similar codes

Compare codes

27759 vs 27758 vs 27756 vs 27752 vs 27750: national Medicare rates

Swap in your local Medicare rate.

  • 27759
    Tibial fracture repair · 14.09 wRVU
    —
  • 27758
    Tibia fracture fixation · 12.23 wRVU
    —
  • 27756
    Fracture fixation · 7.26 wRVU
    —
  • 27752
    Tibial fracture care · 6.11 wRVU
    $608.23
  • 27750
    Tibia fracture care · 3.29 wRVU
    $395.47

How to choose

27758Tibia fracture fixation
Choose 27759 when the tibial shaft fracture is stabilized with an intramedullary implant; choose 27758 for fixation using a plate and screws.
27756Fracture fixation
27756 describes percutaneous skeletal fixation of the tibial shaft fracture. 27759 is the intramedullary implant treatment code.
27752Tibial fracture care
27752 is closed treatment with manipulation, with or without skeletal traction. It does not describe operative intramedullary fixation.
27750Tibia fracture care
27750 is closed tibial shaft fracture treatment without manipulation; 27759 is operative treatment using an intramedullary implant.

27759 billing questions

How is 27759 different from 27758?

27759 is for operative tibial shaft fracture treatment using an intramedullary implant. 27758 is the related option when fixation uses a plate and screws rather than an intramedullary implant.

When would 27756 be more appropriate?

Use 27756 for percutaneous skeletal fixation of a tibial shaft fracture. 27759 describes operative treatment using an intramedullary implant.

Does the global period include routine postoperative care?

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

How is bilateral treatment reported?

For bilateral tibial shaft fractures treated in the same session, report modifier 50; CMS pays the bilateral procedure at 150%.

Can an assistant or co-surgeon be paid?

CMS permits assistant-at-surgery payment and co-surgeons for this code. Team surgery is not permitted.

What operative documentation supports 27759?

Document that the fracture is in the tibial shaft and describe intramedullary implant fixation, including any interlocking screws or cerclage used.

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 27759PPRRVU2026_Oct_nonQPP.csv, line 3,040 (RVU26D)

Open CMS sourceHow we calculate rates

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