$323.08
Both address a proximal fibula or shaft fracture. Choose 27781 when manipulation is performed; choose 27780 when treatment is without manipulation.
On this page
CMS RVU26D · Effective 2026-10-01
27781 Fibula fracture care Medicare reimbursement rates in Nebraska
Physicians report 27781 when they manipulate a proximal fibular or shaft fracture and continue nonoperative care without opening the fracture site. Compare 27781 office and facility rates across CMS payment localities in Nebraska.
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 27781 in Nebraska?
Nebraska 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
$447.47
1 of 1 localities have a supported rate.
Payment area: Nebraska
One mapped payment locality.
Facility setting
$371.02
1 of 1 localities have a supported rate.
Payment area: Nebraska
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 27781: Closed proximal fibula fracture reduction
Physicians report 27781 when they manipulate a proximal fibular or shaft fracture and continue nonoperative care without opening the fracture site.
Code 27781 represents closed management of a fracture in the proximal fibula or fibular shaft when the clinician performs a manipulation to improve alignment. An orthopedic surgeon typically provides the reduction and directs immobilization and follow-up, often in a hospital, emergency department, or office setting. The fracture is managed without surgically opening the site; a cast or other immobilization may be part of the care.
Report the code when the documented fracture location and treatment support manipulation, rather than immobilization alone. The record should identify the fracture site and describe the reduction maneuver and subsequent treatment. CMS assigns a 90-day global period, which includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and others at 50%. Bilateral treatment with modifier 50 is paid at 150%. Assistant-at-surgery services are not paid, and co-surgeons and team surgery are not permitted.
CMS billing rules for 27781
- 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 RVU4.48 · 30%
- Practice expense (office) RVU9.28 · 63%
- Malpractice RVU0.93 · 6%
435
Medicare services in 2024 · #3666 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.
27781 compared with similar codes
Office rates for Nebraska, from the same CMS release.
No office rate
27781 describes closed treatment with manipulation. 27784 is the open-treatment option for a proximal fibula or shaft fracture.
$453.88
Both involve manipulation, but 27788 is for a distal fibular fracture; 27781 is for the proximal fibula or shaft.
Compare 27781 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
Nebraska →
Office / nonfacility
$447.47
Facility
$371.02
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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 27781 in Nebraska.
PPRRVU2026_Oct_nonQPP.csv
3,048
- Code
- 27781
- Physician work
- 4.48
- Practice expense
- 9.28
- Malpractice
- 0.93
GPCI2026.csv
72
- Locality
- Nebraska
- Physician work
- 1.000
- Practice expense
- 0.923
- Malpractice
- 0.378
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 4.48 | × 1.000 | 4.4800 |
| Practice expense | 9.28 | × 0.923 | 8.5654 |
| Malpractice | 0.93 | × 0.378 | 0.3515 |
| Total RVUs | 13.3970 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Nebraska$447.47
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 4.48 | 1 |
| Practice expense | 9.28 | 0.923 |
| Malpractice | 0.93 | 0.378 |
(4.48 × 1 + 9.28 × 0.923 + 0.93 × 0.378) × $33.4009 = $447.47
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 4.48 | 1 |
| Practice expense | 6.8 | 0.923 |
| Malpractice | 0.93 | 0.378 |
(4.48 × 1 + 6.8 × 0.923 + 0.93 × 0.378) × $33.4009 = $371.02
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.
27781 billing questions
How does 27781 differ from 27780?
27781 is for a proximal fibula or shaft fracture treated with manipulation. Use 27780 when the same fracture location is treated without manipulation.
Does placing a cast qualify as manipulation?
No. The record should support a reduction maneuver to improve fracture alignment; immobilization alone points to treatment without manipulation.
When should 27784 be considered instead?
27784 describes open treatment of a proximal fibula or shaft fracture. It is the relevant comparison when the fracture site is surgically opened for treatment.
Can 27781 be reported for a distal fibula fracture?
No. This code is for the proximal fibula or shaft. Distal fibular fractures are represented by codes such as 27786 or 27788, depending on whether manipulation is performed.
How is bilateral treatment reported?
For bilateral treatment, report modifier 50; CMS lists payment at 150% for the bilateral procedure.
What follow-up care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
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.
3,04527768,,Cltx post ankle fx w/mnpj,A,,5.01,7.16,NA,7.16,,1.07,13.24,13.24,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,04627769,,Optx post ankle fx,A,,9.89,8.37,NA,8.37,,1.97,20.23,20.23,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,04727780,,Treatment of fibula fracture,A,,2.76,7.26,,5.60,,0.56,10.58,8.92,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,04827781,,Treatment of fibula fracture,A,,4.48,9.28,,6.80,,0.93,14.69,12.21,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,04927784,,Treatment of fibula fracture,A,,9.43,8.86,NA,8.86,,1.86,20.15,20.15,0,090,0.10,0.69,0.21,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,05027786,,Treatment of ankle fracture,A,,2.94,7.00,,5.31,,0.54,10.48,8.79,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,05127788,,Treatment of ankle fracture,A,,4.52,9.42,,6.89,,0.99,14.93,12.40,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6905302,MO,01,METROPOLITAN ST. LOUIS,1.000,0.952,1.002
7005302,MO,99,REST OF MISSOURI,1.000,0.862,0.974
7103202,MT,01,MONTANA**,1.000,1.000,0.998
7205402,NE,00,NEBRASKA,1.000,0.923,0.378
7301312,NV,00,NEVADA**,1.000,1.001,0.833
7414312,NH,40,NEW HAMPSHIRE,1.000,1.041,0.875
7512402,NJ,01,NORTHERN NJ,1.063,1.160,1.068