27524 Patellar fracture repair Medicare reimbursement rates in Massachusetts

This code covers open surgical treatment of a kneecap fracture. The surgeon exposes the fracture, restores alignment, and stabilizes it with fixation when performed; the procedure may instead or also include partial or complete removal of the patella and repair of associated soft tissue. Orthopedic surgeons most often perform it in a hospital operating room or ambulatory surgery center for a fracture requiring operative treatment.

Select the code from the procedure actually performed, not the fracture image alone: closed treatment belongs to a different patellar-fracture code. The operative report should identify the patella and side, open approach, fracture treatment, fixation or patellectomy performed, and soft-tissue repair. 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%. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.