Billing code 27784: Fibula fractureMedicare rate & RVUs in Illinois
Reports open surgical treatment of a proximal fibula or fibular shaft fracture, with internal fixation when performed, rather than closed fracture care.
CMS doesn’t publish an office rate for 27784 in Illinois.
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 27784 covers
This code describes operative treatment of a fracture in the proximal fibula or fibular shaft. The surgeon exposes and directly treats the fracture; internal fixation may be used when indicated. Orthopedic surgeons typically perform the procedure in a hospital operating room or another surgical facility. A fracture of the distal fibula at the lateral malleolus is a different anatomic site and is coded separately.
Choose the code based on the documented fracture location and open operative approach, not simply on whether hardware is present. The operative report should identify the proximal fibula or shaft fracture and describe the surgical treatment and any fixation. Medicare assigns a 90-day global period, including the day before surgery and 90 days of related postoperative care. For same-session multiple procedures, 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 is restricted; co-surgeon payment requires supporting documentation, and 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 27784 pays more and less in Illinois
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Chicago | Unavailable | $757.17 |
| East St. Louis | Unavailable | $712.35 |
| Rest Of Illinois | Unavailable | $682.26 |
| Suburban Chicago | Unavailable | $731.18 |
How the 27784 rate is calculated
Each of 27784’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 · 27784
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 9.43Practice expense 8.86Malpractice 1.86
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 27784
27784 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 27784
Fibula fracture
| 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) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| 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 · 27784
Fibula fracture
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
27784 without 50 · national facility
$673.03
Fibula fracture
27784-50 · Bilateral: 150%
$1,009.55
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).
27784 compared with similar codes
Compare codes
27784 vs 27780 vs 27781 vs 27792 vs 27726: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 27780Fibula fracture care
- Use 27780 for closed treatment of a proximal or shaft fibula fracture without manipulation. Use 27784 when the fracture is treated operatively through an open approach.
- 27781Fibula fracture care
- Use 27781 for closed treatment of a proximal or shaft fibula fracture with manipulation; 27784 describes open operative treatment.
- 27792Ankle fracture surgery
- 27792 is for open treatment of a distal fibula fracture at the lateral malleolus. 27784 applies to a proximal fibula or fibular shaft fracture.
- 27726Fibula repair
- 27726 addresses repair of a fibular nonunion, not open treatment of an acute proximal or shaft fracture.
27784 billing questions
How is this code distinguished from 27780 or 27781?
27784 describes open treatment of a proximal fibula or shaft fracture. Codes 27780 and 27781 describe closed treatment of those fractures, without and with manipulation, respectively.
Does a fracture of the lateral malleolus belong here?
No. A distal fibula fracture at the lateral malleolus is treated under the ankle fracture codes, such as 27792 for open treatment.
Is internal fixation required to report 27784?
The code covers open treatment, with internal fixation when performed. Documentation should establish the fracture site and direct operative treatment; hardware alone does not establish the code.
What postoperative care is included?
Medicare assigns a 90-day global period, including the day before surgery and 90 days of related postoperative care.
Can an assistant or co-surgeon be reported?
Medicare does not pay an assistant at surgery for this code. Co-surgeon payment is available only with supporting documentation; team surgery is not permitted.
How does Medicare handle bilateral reporting or other same-session procedures?
Bilateral reporting with modifier 50 is paid at 150%. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others are subject to the standard 50% 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 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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