No office rate
Use 27278 for intra-articular implants without a transfixation device. Use 27279 when the operative technique places a transfixation device across the SI joint.
On this page
CMS RVU26D · Effective 2026-10-01
27278 SI joint fusion Medicare reimbursement rates in Rhode Island
Reports percutaneous sacroiliac joint arthrodesis using intra-articular implants without a transfixation device, with image guidance included. Compare 27278 office and facility rates across CMS payment localities in Rhode Island.
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 27278 in Rhode Island?
Rhode Island 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
$14201.15
1 of 1 localities have a supported rate.
Payment area: Rhode Island
One mapped payment locality.
Facility setting
$446.13
1 of 1 localities have a supported rate.
Payment area: Rhode Island
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 surgery
About 27278: Percutaneous SI joint fusion with intra-articular implants
Reports percutaneous sacroiliac joint arthrodesis using intra-articular implants without a transfixation device, with image guidance included.
A surgeon uses a percutaneous approach to fuse the sacroiliac joint by placing implant(s) within the joint without a transfixation device. The procedure may be considered for selected patients with symptomatic SI joint conditions, such as degenerative joint disease or SI joint dysfunction. Orthopedic and spine surgeons typically perform it in an operating room or other procedural setting, using image guidance to place the implants.
Choose this code when the operative report supports the intra-articular implant technique; a transfixation-device approach is reported with a different code. Image guidance is included. Documentation should identify the treated joint, approach, implant placement, and arthrodesis performed. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.
CMS billing rules for 27278
- 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 is paid only with documentation of medical necessity.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU7.66 · 2%
- Practice expense (office) RVU403.30 · 98%
- Malpractice RVU0.85 · 0%
2.6K
Medicare services in 2024 · #2284 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.
27278 compared with similar codes
Office rates for Rhode Island, from the same CMS release.
No office rate
27280 describes open SI joint arthrodesis. This code describes percutaneous arthrodesis with intra-articular implants and no transfixation device.
27299
No office rateUnlisted px pelvis/hip joint
Use this specific code when the documented technique matches its percutaneous intra-articular implant service. Reserve 27299 for a procedure not described by a specific code.
Compare 27278 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
Rhode Island →
Office / nonfacility
$14201.15
Facility
$446.13
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.
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 27278 in Rhode Island.
PPRRVU2026_Oct_nonQPP.csv
2,819
- Code
- 27278
- Physician work
- 7.66
- Practice expense
- 403.30
- Malpractice
- 0.85
GPCI2026.csv
92
- Locality
- Rhode Island
- Physician work
- 1.019
- Practice expense
- 1.033
- Malpractice
- 0.892
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 7.66 | × 1.019 | 7.8055 |
| Practice expense | 403.30 | × 1.033 | 416.6089 |
| Malpractice | 0.85 | × 0.892 | 0.7582 |
| Total RVUs | 425.1726 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Rhode Island$14201.15
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 7.66 | 1.019 |
| Practice expense | 403.3 | 1.033 |
| Malpractice | 0.85 | 0.892 |
(7.66 × 1.019 + 403.3 × 1.033 + 0.85 × 0.892) × $33.4009 = $14201.15
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 7.66 | 1.019 |
| Practice expense | 4.64 | 1.033 |
| Malpractice | 0.85 | 0.892 |
(7.66 × 1.019 + 4.64 × 1.033 + 0.85 × 0.892) × $33.4009 = $446.13
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.
27278 billing questions
How does this differ from 27279?
This code describes intra-articular implant placement without a transfixation device. Code 27279 is for SI joint arthrodesis with placement of a transfixation device.
Can image guidance be reported separately?
No. Image guidance used for this arthrodesis is included in the service.
How should bilateral SI joint fusion be reported?
Use modifier 50 for a bilateral procedure. CMS pays the bilateral service at 150%.
What documentation supports this code?
The operative report should identify the SI joint treated, the percutaneous approach, arthrodesis, and intra-articular implant placement without a transfixation device.
Is postoperative care included?
Yes. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
When is assistant-at-surgery payment allowed?
CMS allows assistant-at-surgery payment only when medical necessity is documented.
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.
2,81627268,,Cltx thigh fx w/mnpj,A,,6.94,7.05,NA,7.05,,1.47,15.46,15.46,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,81727269,,Optx thigh fx,A,,18.42,11.26,NA,11.26,,3.89,33.57,33.57,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,81827275,,Manipulation of hip joint,A,,2.26,2.63,NA,2.63,,0.46,5.35,5.35,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,81927278,,Arthrd si jt plmt iartic dev,A,,7.66,403.30,,4.64,,0.85,411.81,13.15,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,82027279,,Arthrd si jt plmt tartclr dv,A,,11.83,8.26,NA,8.26,,2.62,22.71,22.71,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,82127280,,Arthr si jt opn b1grf instrm,A,,19.50,12.89,NA,12.89,,6.04,38.43,38.43,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,82227282,,Arthrodesis symphysis pubis,A,,11.55,10.03,NA,10.03,,2.47,24.05,24.05,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
8912502,PA,01,METROPOLITAN PHILADELPHIA,1.018,1.041,1.193
9012502,PA,99,REST OF PENNSYLVANIA,1.000,0.918,0.945
9109202,PR,20,PUERTO RICO,1.000,1.011,0.985
9214412,RI,01,RHODE ISLAND,1.019,1.033,0.892
9311202,SC,01,SOUTH CAROLINA,1.000,0.924,0.850
9403402,SD,02,SOUTH DAKOTA**,1.000,1.000,0.336
9510312,TN,35,TENNESSEE,1.000,0.909,0.537