Billing code 27226: Acetabular repairMedicare rate & RVUs in Guam
Report open operative treatment of an acetabular fracture involving one column when the fracture pattern does not include an acetabular wall fracture.
CMS doesn’t publish an office rate for 27226 in Guam.
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 27226 covers
An orthopedic trauma surgeon uses an open approach to reduce and stabilize an acetabular fracture involving the anterior or posterior column. The operation is generally performed in a hospital operating room for a fracture requiring open treatment; internal fixation is included when performed. The code is distinguished by the fracture pattern, not simply by the surgical approach or the hardware used.
Choose this code from the operative findings and documentation of the injured acetabular column and whether a wall fracture is also present. Document the fracture pattern, open reduction and treatment performed, and fixation when used. The day-before preoperative visit and 90 days of related postoperative care are included in the major-surgery global period. For same-session procedures subject to the standard multiple procedure reduction, the highest-valued procedure is paid in full and the others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be available, 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.
27226 in Hawaii, Guam
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam | Unavailable | $969.96 |
How the 27226 rate is calculated
Each of 27226’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 · 27226
RVUs × geographic indexes × conversion factor
Work15.18
15.18 RVUs× 1.000 GPCI
Practice expense10.54
10.54 RVUs× 1.000 GPCI
Malpractice3.24
3.24 RVUs× 1.000 GPCI
Adjusted RVUs
28.9600
Conversion factor
$33.4009
Medicare rate
$967.29
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 27226
27226 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 27226
Acetabular 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 · 27226
Acetabular 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
27226 without 50 · national facility
$967.29
Acetabular repair
27226-50 · Bilateral: 150%
$1,450.94
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).
27226 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 27227Acetabular fracture
- Both describe open treatment of a one-column acetabular fracture; 27227 is the code to compare when the fracture also involves an acetabular wall.
- 27228Acetabular fracture repair
- Use 27228 for an acetabular fracture involving two columns, rather than the one-column pattern represented by 27226.
- 27220Acetabular fracture care
- 27220 describes closed treatment without manipulation. This code is for open treatment of a one-column acetabular fracture.
- 27222Acetabular fracture
- 27222 describes closed treatment with manipulation; it is not the open treatment code for a one-column acetabular fracture.
27226 billing questions
How is this code distinguished from 27227?
Use 27226 for open treatment of a fracture involving one acetabular column without an associated wall fracture. When the one-column fracture also involves an acetabular wall, compare 27227.
Is internal fixation separately reported?
No. Internal fixation, when performed as part of the open fracture treatment, is included in this code.
What supports choosing this code?
The operative report should identify the acetabular fracture pattern, including the involved column and whether a wall fracture is present, and describe the open treatment performed.
How does the global period affect postoperative billing?
The major-surgery global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be available, and co-surgeons are permitted. Team surgery is not permitted under the CMS rules supplied 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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