No office rate
Use 27720 for tibial nonunion or malunion repair without graft; use 27724 when the repair uses autogenous bone graft.
On this page
CMS RVU26D · Effective 2026-10-01
27724 Tibia repair Medicare reimbursement rates in Guam
Reports operative repair of a tibial nonunion or malunion using an autogenous bone graft, such as graft harvested from the iliac crest. Compare 27724 office and facility rates across CMS payment localities in Guam.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 27724 in Guam?
Guam has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$1130.10
1 of 1 localities have a supported rate.
Payment area: Hawaii, Guam
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Orthopedic surgery
About 27724: Tibial nonunion repair with bone graft
Reports operative repair of a tibial nonunion or malunion using an autogenous bone graft, such as graft harvested from the iliac crest.
This service addresses a tibial fracture that has failed to unite or has healed in a position requiring operative correction. The orthopedic surgeon prepares the fracture site and uses autogenous bone graft to support healing; graft may be harvested from the iliac crest or another site. It is performed in an operating room, commonly for persistent tibial nonunion after fracture treatment. The graft-harvest work is included in this code’s service.
Select this code when the documented tibial nonunion or malunion repair uses autogenous graft, rather than a sliding graft, no graft, or the intramedullary-rod approach represented by related codes. The operative report should identify the tibial site, the nonunion or malunion, the graft type and source, and the repair performed. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. In a same-session multiple-procedure claim, 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 may be made; co-surgeons require supporting documentation, and team surgery is not permitted.
CMS billing rules for 27724
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral procedure with modifier 50 is paid at 150%.
- Assistant at surgery
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU18.83 · 55%
- Practice expense (office) RVU11.18 · 33%
- Malpractice RVU3.96 · 12%
356
Medicare services in 2024 · #3835 by national volume
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.
27724 compared with similar codes
Office rates for Guam, from the same CMS release.
No office rate
Use 27722 for a sliding-graft repair. This code applies when another autogenous bone graft approach is used.
No office rate
Use 27725 for tibial nonunion or malunion repair with an intramedullary rod. This code distinguishes repair using autogenous bone graft.
Compare 27724 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Hawaii, Guam →
Office / nonfacility
Unavailable
Facility
$1130.10
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 27724 in Hawaii, Guam.
PPRRVU2026_Oct_nonQPP.csv
3,026
- Code
- 27724
- Physician work
- 18.83
- Practice expense
- 11.18
- Malpractice
- 3.96
GPCI2026.csv
46
- Locality
- Hawaii, Guam
- Physician work
- 1.000
- Practice expense
- 1.137
- Malpractice
- 0.579
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 18.83 | × 1.000 | 18.8300 |
| Practice expense | 11.18 | × 1.137 | 12.7117 |
| Malpractice | 3.96 | × 0.579 | 2.2928 |
| Total RVUs | 33.8345 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Hawaii, Guam$1130.10
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 18.83 | 1 |
| Practice expense | 11.18 | 1.137 |
| Malpractice | 3.96 | 0.579 |
(18.83 × 1 + 11.18 × 1.137 + 3.96 × 0.579) × $33.4009 = $1130.10
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
27724 billing questions
When should this code be chosen instead of 27720?
Use this code when the tibial nonunion or malunion repair includes autogenous bone graft. Code 27720 represents repair without graft.
How does this differ from 27722?
Code 27722 represents repair using a sliding graft. This code is for repair using another autogenous bone graft approach, such as graft harvested from the iliac crest.
Is graft harvesting separately reported?
The graft-harvest work is included in this code’s service. Document the graft type and source in the operative report.
What documentation supports reporting this code?
Document the tibial nonunion or malunion, its site, the repair performed, and the use and source of autogenous graft.
How are same-session procedures and bilateral cases handled?
For multiple procedures in one session, the highest-valued procedure is paid in full and others are subject to the standard 50% reduction. Bilateral reporting with modifier 50 is paid at 150%.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be made. Co-surgeons are paid only with supporting documentation; team surgery is not permitted.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
3,02327715,,Ostpl tibfib lngth/shrt,A,,21.94,14.16,NA,14.16,,4.68,40.78,40.78,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,02427720,,Repair of tibia,A,,12.05,9.83,NA,9.83,,2.41,24.29,24.29,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,02527722,,Repair/graft of tibia,A,,12.14,10.22,NA,10.22,,2.59,24.95,24.95,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,02627724,,Repair/graft of tibia,A,,18.83,11.18,NA,11.18,,3.96,33.97,33.97,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,02727725,,Repair of lower leg,A,,16.97,13.06,NA,13.06,,3.61,33.64,33.64,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,02827726,,Repair fibula nonunion,A,,13.98,9.46,NA,9.46,,2.76,26.20,26.20,0,090,0.10,0.69,0.21,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,02927727,,Repair of lower leg,A,,14.47,11.15,NA,11.15,,3.06,28.68,28.68,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503
4410212,GA,01,ATLANTA,1.003,1.016,1.201
4510212,GA,99,REST OF GEORGIA,1.000,0.892,1.192
4601212,HI,01,"HAWAII, GUAM",1.000,1.137,0.579
4702202,ID,00,IDAHO,1.000,0.920,0.473
4806102,IL,16,CHICAGO,1.007,1.005,2.295
4906102,IL,12,EAST ST. LOUIS,1.000,0.920,2.014