No office rate
Use 27725 when the repair with intramedullary rod insertion is limited to the tibia. This code is for repair involving both the tibia and fibula.
On this page
CMS RVU26D · Effective 2026-10-01
27727 Lower-leg repair Medicare reimbursement rates in Vermont
Reports operative repair of a tibial and fibular nonunion or malunion when an intramedullary rod is inserted as part of the reconstruction. Compare 27727 office and facility rates across CMS payment localities in Vermont.
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 27727 in Vermont?
Vermont 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
$903.72
1 of 1 localities have a supported rate.
Payment area: Vermont
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 27727: Tibia and fibula nonunion repair with rod
Reports operative repair of a tibial and fibular nonunion or malunion when an intramedullary rod is inserted as part of the reconstruction.
This service addresses a tibial and fibular fracture that has failed to unite or healed in a position requiring operative correction. The surgeon repairs both lower-leg bones and inserts an intramedullary rod as part of the reconstruction. It is typically performed by an orthopedic surgeon in a hospital or ambulatory surgical setting; the operative report should identify the affected bones, the nonunion or malunion, and the rod insertion.
Select this code when the repair involves both the tibia and fibula and includes intramedullary rod insertion; a tibia-only repair or fibula-only repair points to a different code. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be available; co-surgeons require supporting documentation, and team surgery is not permitted.
CMS billing rules for 27727
- 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 paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU14.47 · 50%
- Practice expense (office) RVU11.15 · 39%
- Malpractice RVU3.06 · 11%
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.
27727 compared with similar codes
Office rates for Vermont, from the same CMS release.
No office rate
Use 27726 for a fibula-only nonunion or malunion repair. This code involves both lower-leg bones and includes rod insertion.
No office rate
27724 applies to a tibia-only repair using iliac or other autograft. This code describes repair of both the tibia and fibula with rod insertion.
Compare 27727 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
Vermont →
Office / nonfacility
Unavailable
Facility
$903.72
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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 27727 in Vermont.
PPRRVU2026_Oct_nonQPP.csv
3,029
- Code
- 27727
- Physician work
- 14.47
- Practice expense
- 11.15
- Malpractice
- 3.06
GPCI2026.csv
105
- Locality
- Vermont
- Physician work
- 1.000
- Practice expense
- 0.990
- Malpractice
- 0.506
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 14.47 | × 1.000 | 14.4700 |
| Practice expense | 11.15 | × 0.990 | 11.0385 |
| Malpractice | 3.06 | × 0.506 | 1.5484 |
| Total RVUs | 27.0569 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Vermont$903.72
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 14.47 | 1 |
| Practice expense | 11.15 | 0.99 |
| Malpractice | 3.06 | 0.506 |
(14.47 × 1 + 11.15 × 0.99 + 3.06 × 0.506) × $33.4009 = $903.72
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.
27727 billing questions
When should I choose this code instead of 27725?
Use this code when the nonunion or malunion repair involves both the tibia and fibula and includes intramedullary rod insertion. Code 27725 describes a tibia-only repair with rod insertion.
Is the intramedullary rod part of the service?
Yes. Rod insertion is part of the repair described by this code; document it in the operative report.
Can this code be reported bilaterally?
For bilateral procedures, CMS payment is 150% when modifier 50 is used. Document the service on both sides.
How does the multiple-procedure reduction affect payment?
For procedures performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to a 50% reduction.
What documentation supports reporting this code?
The operative report should establish nonunion or malunion involving both the tibia and fibula and describe the repair and intramedullary rod insertion.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be available. Co-surgeons are paid only with supporting documentation; 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.
3,02627724,,Repair/graft of tibia,A,,18.83,11.18,NA,11.18,,3.96,33.97,33.97,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,02727725,,Repair of lower leg,A,,16.97,13.06,NA,13.06,,3.61,33.64,33.64,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,02827726,,Repair fibula nonunion,A,,13.98,9.46,NA,9.46,,2.76,26.20,26.20,0,090,0.10,0.69,0.21,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,02927727,,Repair of lower leg,A,,14.47,11.15,NA,11.15,,3.06,28.68,28.68,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,03027730,,Repair of tibia epiphysis,A,,7.51,7.68,NA,7.68,,1.61,16.80,16.80,0,090,0.10,0.69,0.21,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,03127732,,Repair of fibula epiphysis,A,,5.32,6.77,NA,6.77,,1.14,13.23,13.23,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,03227734,,Repair lower leg epiphyses,A,,8.61,8.19,NA,8.19,,1.83,18.63,18.63,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
10204412,TX,18,HOUSTON,1.008,0.993,1.376
10304412,TX,99,REST OF TEXAS,1.000,0.949,0.903
10403502,UT,09,UTAH,1.000,0.940,0.898
10514512,VT,50,VERMONT,1.000,0.990,0.506
10611302,VA,00,VIRGINIA,1.000,0.983,0.706
10709202,VI,50,VIRGIN ISLANDS,1.000,1.011,0.985
10802402,WA,02,SEATTLE (KING CNTY),1.050,1.227,0.817