No office rate
Use 27827 for open pilon fracture treatment without fibular fixation. When the fibula is fixed as part of the treatment, 27828 is the distinguishing code.
On this page
CMS RVU26D · Effective 2026-10-01
27828 Pilon fracture repair Medicare reimbursement rates in Missouri
Open fixation of a distal tibial pilon fracture with fibular fixation, reported when operative treatment addresses both the tibial plafond injury and fibula. Compare 27828 office and facility rates across CMS payment localities in Missouri.
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 27828 in Missouri?
Missouri has 3 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 3 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$1156.84–$1206.00
3 of 3 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 27828 pays more and less in Missouri
Orthopedic surgery
About 27828: Pilon fracture repair with fibular fixation
Open fixation of a distal tibial pilon fracture with fibular fixation, reported when operative treatment addresses both the tibial plafond injury and fibula.
An orthopedic surgeon typically reports this service for open operative treatment of a distal tibial pilon or tibial plafond fracture when the fibula is also fixed. These injuries often require hospital operating-room care, particularly when the fracture involves the weight-bearing surface of the ankle. The code accounts for internal fixation of the tibia and, when performed, fixation of the fibula as part of the pilon fracture treatment.
Select this code when the operative report supports open treatment of the distal tibial fracture and documents fibular fixation; use the related pilon code 27827 when fibular fixation is not performed. Documentation should identify the fracture sites, open approach, and fixation 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 setting, the highest-valued procedure is paid in full and other procedures at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment and co-surgeons are permitted; team surgery is not permitted.
CMS billing rules for 27828
- 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 permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU17.97 · 49%
- Practice expense (office) RVU15.22 · 41%
- Malpractice RVU3.64 · 10%
1.6K
Medicare services in 2024 · #2610 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.
27828 compared with similar codes
Office rates for Missouri, from the same CMS release.
No office rate
27826 describes open treatment of a distal fibular fracture. It does not describe the combined pilon fracture treatment with fibular fixation represented by 27828.
No office rate
27829 addresses open treatment of a distal tibiofibular syndesmosis disruption. Choose based on the operative condition treated, rather than treating syndesmosis repair as pilon fracture fixation.
No office rate
27822 is for open treatment of a trimalleolar ankle fracture without fixation of the posterior lip. It is not the pilon fracture code for distal tibial plafond involvement with fibular fixation.
Compare 27828 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.
3 of 3 payment localities
Metropolitan Kansas City →
Office / nonfacility
Unavailable
Facility
$1196.35
Metropolitan St. Louis →
Office / nonfacility
Unavailable
Facility
$1206.00
Rest Of Missouri →
Office / nonfacility
Unavailable
Facility
$1156.84
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
27828 billing questions
How does 27828 differ from 27827?
Both apply to open treatment of a distal tibial pilon or plafond fracture. Use 27828 when the fibula is also fixed; 27827 applies when fibular fixation is not performed.
Can the internal fixation be reported separately?
No separate fixation service is represented by this code; internal fixation is included in the pilon fracture treatment.
What should the operative report document?
Document the distal tibial pilon or plafond fracture, the open treatment, and the fibular fixation performed. The report should make clear that the fibular work occurred as part of the fracture treatment.
What is included in the global period?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How does Medicare handle another procedure performed in the same session?
The highest-valued procedure is paid in full, and other procedures are paid at 50%. Bilateral reporting with modifier 50 is paid at 150%.
May an assistant or co-surgeon be reported?
Assistant-at-surgery payment and co-surgeons are permitted for this code. 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.
3,06127825,,Treat lower leg fracture,A,,6.52,10.22,,6.47,,1.35,18.09,14.34,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,06227826,,Treat lower leg fracture,A,,10.82,11.43,NA,11.43,,2.09,24.34,24.34,0,090,0.10,0.69,0.21,2,1,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,06327827,,Treat lower leg fracture,A,,14.42,14.17,NA,14.17,,2.94,31.53,31.53,0,090,0.10,0.69,0.21,2,1,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,06427828,,Treat lower leg fracture,A,,17.97,15.22,NA,15.22,,3.64,36.83,36.83,0,090,0.10,0.69,0.21,2,1,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,06527829,,Treat lower leg joint,A,,8.58,9.94,NA,9.94,,1.63,20.15,20.15,0,090,0.10,0.69,0.21,2,1,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,06627830,,Treat lower leg dislocation,A,,3.86,8.34,,6.11,,0.83,13.03,10.80,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,06727831,,Treat lower leg dislocation,A,,4.61,6.45,NA,6.45,,1.00,12.06,12.06,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00