$12,598.87–$14,142.24
This code describes open fusion with graft and instrumentation. Code 27278 is for percutaneous or minimally invasive fusion with intra-articular implant placement.
On this page
CMS RVU26D · Effective 2026-10-01
27280 SI joint fusion Medicare reimbursement rates in Illinois
Report this code for open fusion of the sacroiliac joint using bone graft and instrumentation, rather than a percutaneous or minimally invasive approach. Compare 27280 office and facility rates across CMS payment localities in Illinois.
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 27280 in Illinois?
Illinois has 4 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 4 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$1359.72–$1551.56
4 of 4 localities have a supported rate.
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.
Where 27280 pays more and less in Illinois
Orthopedic surgery
About 27280: Open sacroiliac joint fusion with graft
Report this code for open fusion of the sacroiliac joint using bone graft and instrumentation, rather than a percutaneous or minimally invasive approach.
This service is an open operation to fuse the sacroiliac joint. The surgeon exposes the joint, prepares the opposing surfaces for fusion, places bone graft, and uses instrumentation to support the construct. It is commonly performed by an orthopedic or spine surgeon in a hospital operating room for a patient undergoing surgical treatment of sacroiliac joint disease or instability.
Select this code when the operative report supports an open approach with graft and instrumentation; distinguish it from percutaneous or minimally invasive SI joint fusion codes based on the documented technique and implant placement. Documentation should identify the treated side, approach, joint preparation, graft use, and instrumentation. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures 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; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 27280
- 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 RVU19.50 · 51%
- Practice expense (office) RVU12.89 · 34%
- Malpractice RVU6.04 · 16%
4.5K
Medicare services in 2024 · #1942 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.
27280 compared with similar codes
Office rates for Illinois, from the same CMS release.
No office rate
Choose this code for the open, grafted procedure. Code 27279 describes percutaneous or minimally invasive fusion using a transfixing device.
27299
No office rateUnlisted px pelvis/hip joint
Code 27299 is for an unlisted pelvis or hip joint procedure when no specific code describes the service; ordinary open SI joint fusion is specifically described by this code.
Compare 27280 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.
4 of 4 payment localities
Chicago →
Office / nonfacility
Unavailable
Facility
$1551.56
East St. Louis →
Office / nonfacility
Unavailable
Facility
$1453.72
Rest Of Illinois →
Office / nonfacility
Unavailable
Facility
$1359.72
Suburban Chicago →
Office / nonfacility
Unavailable
Facility
$1455.52
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27280 billing questions
How does this code differ from percutaneous SI joint fusion codes?
Use this code for an open operation with bone graft and instrumentation. Codes 27278 and 27279 describe percutaneous or minimally invasive approaches distinguished by implant placement.
What operative details support reporting this code?
Document the open approach, the SI joint treated, preparation of the joint surfaces, bone graft use, and placement of instrumentation.
Can both sides be reported?
For a bilateral procedure, report modifier 50; CMS pays the bilateral procedure at 150%.
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.
Can an assistant or co-surgeon be paid?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
How are other procedures in the same session paid?
CMS pays the highest-valued procedure in full and other procedures at 50% under the standard multiple procedure reduction.
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.
2,81827275,,Manipulation of hip joint,A,,2.26,2.63,NA,2.63,,0.46,5.35,5.35,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,81927278,,Arthrd si jt plmt iartic dev,A,,7.66,403.30,,4.64,,0.85,411.81,13.15,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,82027279,,Arthrd si jt plmt tartclr dv,A,,11.83,8.26,NA,8.26,,2.62,22.71,22.71,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,82127280,,Arthr si jt opn b1grf instrm,A,,19.50,12.89,NA,12.89,,6.04,38.43,38.43,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,82227282,,Arthrodesis symphysis pubis,A,,11.55,10.03,NA,10.03,,2.47,24.05,24.05,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,82327284,,Arthrodesis hip joint,A,,24.43,13.38,NA,13.38,,5.19,43.00,43.00,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,82427286,,Arthrd hip jt sbtrchc osteot,A,,24.54,14.57,NA,14.57,,5.22,44.33,44.33,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00