$632.29
Both codes address closed treatment of a proximal tibial plateau fracture; select 27532 when manipulation is performed and 27530 when it is not.
On this page
CMS RVU26D · Effective 2026-10-01
27530 Fracture treatment Medicare reimbursement rates in Kentucky
Reports closed care of a proximal tibial plateau fracture when the clinician treats the fracture without manipulating it to change alignment. Compare 27530 office and facility rates across CMS payment localities in Kentucky.
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 27530 in Kentucky?
Kentucky 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
$320.32
1 of 1 localities have a supported rate.
Payment area: Kentucky
One mapped payment locality.
Facility setting
$277.56
1 of 1 localities have a supported rate.
Payment area: Kentucky
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 fracture care
About 27530: Closed proximal tibial plateau fracture care
Reports closed care of a proximal tibial plateau fracture when the clinician treats the fracture without manipulating it to change alignment.
This code describes closed management of a fracture at the upper end of the tibia involving the knee joint surface, when no manipulation is performed. An orthopedic surgeon or other qualified fracture-care clinician may use it for a fracture managed without surgical exposure or a reduction maneuver, such as a plateau fracture treated with immobilization and clinical follow-up. The fracture site and the treatment actually performed distinguish this service from care of the kneecap or an open plateau repair.
Document the proximal tibial plateau fracture, the closed treatment plan, and that manipulation was not performed. CMS assigns a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures at 50%. For bilateral reporting with modifier 50, CMS pays at 150%. Assistant-at-surgery payment is restricted; co-surgeons and team surgery are not permitted.
CMS billing rules for 27530
- 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
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU2.58 · 25%
- Practice expense (office) RVU7.34 · 70%
- Malpractice RVU0.53 · 5%
5.1K
Medicare services in 2024 · #1855 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.
27530 compared with similar codes
Office rates for Kentucky, from the same CMS release.
No office rate
27535 is for open treatment of a unicondylar plateau fracture. This code describes closed treatment without manipulation.
No office rate
27536 is for open treatment of a plateau fracture involving both condyles; 27530 is closed treatment without manipulation.
$340.21
27520 concerns a patellar fracture, not a fracture of the proximal tibial plateau.
Compare 27530 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
Kentucky →
Office / nonfacility
$320.32
Facility
$277.56
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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 27530 in Kentucky.
PPRRVU2026_Oct_nonQPP.csv
2,939
- Code
- 27530
- Physician work
- 2.58
- Practice expense
- 7.34
- Malpractice
- 0.53
GPCI2026.csv
55
- Locality
- Kentucky
- Physician work
- 1.000
- Practice expense
- 0.889
- Malpractice
- 0.915
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.58 | × 1.000 | 2.5800 |
| Practice expense | 7.34 | × 0.889 | 6.5253 |
| Malpractice | 0.53 | × 0.915 | 0.4850 |
| Total RVUs | 9.5902 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Kentucky$320.32
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.58 | 1 |
| Practice expense | 7.34 | 0.889 |
| Malpractice | 0.53 | 0.915 |
(2.58 × 1 + 7.34 × 0.889 + 0.53 × 0.915) × $33.4009 = $320.32
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.58 | 1 |
| Practice expense | 5.9 | 0.889 |
| Malpractice | 0.53 | 0.915 |
(2.58 × 1 + 5.9 × 0.889 + 0.53 × 0.915) × $33.4009 = $277.56
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.
27530 billing questions
How does this differ from 27532?
Use 27530 when the proximal tibial plateau fracture is treated closed without manipulation. Code 27532 is the related closed-treatment option when manipulation is performed.
Can this code be used for an open plateau repair?
No. Open treatment of a unicondylar plateau fracture is represented by 27535, while 27536 describes open treatment involving both condyles.
Are related follow-up visits included?
Yes. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How does CMS handle bilateral reporting and other procedures in the session?
A bilateral procedure reported with modifier 50 is paid at 150%. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and the others at 50%.
Can an assistant or co-surgeon be reported?
CMS does not pay an assistant at surgery for this code. Co-surgeons and team surgery are not permitted.
What documentation supports reporting 27530?
Record the proximal tibial plateau fracture, the closed treatment plan, and that no manipulation was performed. The treatment documented should match the service reported.
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.
2,93627519,,Treat thigh fx growth plate,A,,12.92,8.61,NA,8.61,,2.75,24.28,24.28,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,93727520,,Treat kneecap fracture,A,,2.96,7.50,,5.74,,0.61,11.07,9.31,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,93827524,,Treat kneecap fracture,A,,10.11,8.89,NA,8.89,,2.11,21.11,21.11,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,93927530,,Treat knee fracture,A,,2.58,7.34,,5.90,,0.53,10.45,9.01,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,94027532,,Treat knee fracture,A,,7.36,11.43,,7.74,,1.54,20.33,16.64,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,94127535,,Treat knee fracture,A,,13.07,8.59,NA,8.59,,2.75,24.41,24.41,0,090,0.10,0.69,0.21,2,1,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,94227536,,Treat knee fracture,A,,16.96,12.10,NA,12.10,,3.60,32.66,32.66,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915
5607202,LA,01,NEW ORLEANS,1.000,0.941,1.136
5707202,LA,99,REST OF LOUISIANA,1.000,0.885,0.958
5814112,ME,03,SOUTHERN MAINE,1.000,0.991,0.631