Billing code 27781: Fibula fracture careMedicare rate & RVUs in Utah

Physicians report 27781 when they manipulate a proximal fibular or shaft fracture and continue nonoperative care without opening the fracture site.

CMS RVU26DEffective Oct 1, 20261 payment locality435 Medicare services in 2024

Medicare pays $468.89 for 27781 in the office in Utah (Utah). Which amount applies depends on the service address.

$468.89Office (non-facility)
$391.03Hospital or facility

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 27781 for the payment locality that covers the ZIP.

On this page 9 sections
  1. Rate in Utah
  2. What 27781 covers
  3. By payment locality
  4. How it’s calculated
  5. Payment rules
  6. Similar codes
  7. Related codes
  8. Billing questions
  9. Sources

What 27781 covers

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.

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 in Utah

27781 office and facility rates by payment locality
Payment localityOfficeFacility
Utah$468.89$391.03

How the 27781 rate is calculated

Each of 27781’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 27781

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 4.48Practice expense 9.28Malpractice 0.93

14.6900 adjusted RVUs×$33.4009 conversion factor=$490.66

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 27781

27781 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 27781

Fibula fracture care

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.69/0.21Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 27781

Fibula fracture care

90-day global period ends

Dec 30, 2026

Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).

Visit on Oct 31, 2026

Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.

  • 24 Unrelated E/M visit by the same physician
  • 79 Unrelated procedure (starts its own global period)
  • 58 Staged, more extensive, or therapy procedure that was planned
  • 78 Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 50 · payment effect

With and without the modifier

27781 without 50 · national office

$490.66

Fibula fracture care

27781-50 · Bilateral: 150%

$735.99

Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).

When to use modifier 50

27781 compared with similar codes

Compare codes

27781 vs 27780 vs 27784 vs 27788: national Medicare rates

Swap in your local Medicare rate.

  • 27781
    Fibula fracture care · 4.48 wRVU
    $490.66
  • 27780
    Fibula fracture care · 2.76 wRVU
    $353.38−$137.28
  • 27784
    Fibula fracture · 9.43 wRVU
    —
  • 27788
    Ankle fracture care · 4.52 wRVU
    $498.68+$8.02

How to choose

27780Fibula fracture care
Both address a proximal fibula or shaft fracture. Choose 27781 when manipulation is performed; choose 27780 when treatment is without manipulation.
27784Fibula fracture
27781 describes closed treatment with manipulation. 27784 is the open-treatment option for a proximal fibula or shaft fracture.
27788Ankle fracture care
Both involve manipulation, but 27788 is for a distal fibular fracture; 27781 is for the proximal fibula or shaft.

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 indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 27781PPRRVU2026_Oct_nonQPP.csv, line 3,048 (RVU26D)
Geographic factors for UtahGPCI2026.csv, line 104 (RVU26D)

Open CMS sourceHow we calculate rates

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