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CMS RVU26D · Effective 2026-10-01

29851 Knee fracture repair Medicare reimbursement rates in Rhode Island

Reports arthroscopically assisted operative repair of a knee intercondylar spine or tuberosity fracture when fixation or repair is performed. Compare 29851 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 29851 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

No supported rate

Facility setting

$871.18

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.

Find 29851 in your payment locality →

Orthopedic surgery

About 29851: Arthroscopic knee fracture fixation

Reports arthroscopically assisted operative repair of a knee intercondylar spine or tuberosity fracture when fixation or repair is performed.

Orthopedic surgeons use 29851 for arthroscopically assisted operative treatment of a fracture involving the knee’s intercondylar spine, also called the tibial eminence, and/or tibial tuberosity, when fixation or repair is performed. A familiar example is arthroscopic reduction and fixation of a displaced tibial spine avulsion. The service is typically performed in a hospital operating room or ambulatory surgery center; it is distinct from a diagnostic-only knee scope and from treatment of a tibial plateau fracture.

Report the service for the treated knee, supported by documentation of the fracture site and the arthroscopic reduction, fixation, or repair performed. Diagnostic arthroscopy of that knee is integral to the operative service. CMS 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 others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment and co-surgeons are permitted; team surgery is not.

CMS billing rules for 29851

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 RVU12.93 · 50%
  • Practice expense (office) RVU10.12 · 39%
  • Malpractice RVU2.75 · 11%

18

Medicare services in 2024 · #5970 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.

29851 compared with similar codes

Office rates for Rhode Island, from the same CMS release.

29850

Knee arthroscopy

Fracture fixation

No office rate

Choose 29851 when fixation or repair is performed for the spine or tuberosity fracture; 29850 is for treatment without internal fixation.

29855

Tibial fracture repair

Arthroscopic, unicondylar

No office rate

29855 addresses an arthroscopically treated unicondylar proximal tibial plateau fracture, rather than a knee spine or tuberosity fracture.

29856

Knee fracture repair

With internal fixation

No office rate

29856 is for arthroscopically aided treatment of a bicondylar proximal tibial plateau fracture.

27535

Tibial plateau fracture

Open, unicondylar treatment

No office rate

Use 27535 for open treatment of a unicondylar proximal tibial plateau fracture; 29851 is arthroscopically assisted treatment of a spine or tuberosity fracture.

Compare 29851 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

Office and facility base rates · shared scale starting at $0

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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 29851 in Rhode Island.

PPRRVU2026_Oct_nonQPP.csv

3,343

Code
29851
Physician work
12.93
Practice expense
10.12
Malpractice
2.75

GPCI2026.csv

92

Locality
Rhode Island
Physician work
1.019
Practice expense
1.033
Malpractice
0.892
Facility calculation for 29851 in Rhode Island
ComponentRVULocality factorAdjusted
Physician work12.93× 1.01913.1757
Practice expense10.12× 1.03310.4540
Malpractice2.75× 0.8922.4530
Total RVUs26.0826
Conversion factor× 33.4009

Facility rate, Rhode Island$871.18

Values as parsed from CMS release RVU26D, effective 2026-10-01. The amount is rounded to the nearest cent only at the end.
Explore RVUs, geographic factors and the full formula

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work12.931.019
Practice expense10.121.033
Malpractice2.750.892

(12.93 × 1.019 + 10.12 × 1.033 + 2.75 × 0.892) × $33.4009 = $871.18

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.

29851 billing questions

How does 29851 differ from 29850?

Use 29851 when the arthroscopically assisted fracture treatment includes internal fixation or repair. Code 29850 describes the corresponding treatment without internal fixation.

Can diagnostic knee arthroscopy be billed separately?

Diagnostic arthroscopy of the same knee is integral to the operative fracture treatment and is not separately reported for that service.

Is the code reported per fracture fragment or per knee?

Report the operative service for the treated knee; the number of fragments or fixation devices does not create additional units.

What documentation supports 29851?

Document the fracture location and the arthroscopically assisted reduction, fixation, or repair performed. The record should distinguish a spine or tuberosity fracture from a tibial plateau fracture.

Can modifier 50 be used for bilateral treatment?

CMS identifies this as a bilateral procedure; bilateral reporting with modifier 50 is paid at 150%.

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.

RVUs for 29851PPRRVU2026_Oct_nonQPP.csv, line 3,343 (RVU26D)
Geographic factors for Rhode IslandGPCI2026.csv, line 92 (RVU26D)