No office rate
Both treat proximal tibial plateau fractures with arthroscopic assistance. Choose 29856 when internal fixation is performed and 29855 when it is not.
On this page
CMS RVU26D · Effective 2026-10-01
29856 Knee fracture repair Medicare reimbursement rates in Vermont
Reports arthroscopically assisted repair of a proximal tibial plateau fracture when the surgeon stabilizes the fracture with internal fixation. Compare 29856 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 29856 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
$865.31
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 29856: Arthroscopic tibial plateau fracture fixation
Reports arthroscopically assisted repair of a proximal tibial plateau fracture when the surgeon stabilizes the fracture with internal fixation.
An orthopedic surgeon uses arthroscopic visualization to help reduce and stabilize a fracture of the upper tibial joint surface, or tibial plateau. The procedure includes internal fixation, such as fixation with screws, and the arthroscopy used to guide the fracture treatment. It is typically performed in an operating room at a hospital or ambulatory surgery center for an intra-articular plateau fracture requiring operative stabilization.
Report this code when the operative note supports a proximal tibial plateau fracture, arthroscopic assistance, and internal fixation. Document the fracture and the reduction and fixation performed; arthroscopy is included in the service. CMS 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 other procedures at 50%. Bilateral reporting with modifier 50 is paid at 150%. An assistant at surgery may be paid, and co-surgeons are permitted; team surgery is not permitted.
CMS billing rules for 29856
- 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 RVU13.92 · 51%
- Practice expense (office) RVU10.59 · 39%
- Malpractice RVU2.97 · 11%
32
Medicare services in 2024 · #5614 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.
29856 compared with similar codes
Office rates for Vermont, from the same CMS release.
No office rate
This code describes open treatment of a unicondylar proximal tibial plateau fracture. 29856 describes arthroscopically assisted treatment with internal fixation.
No office rate
This code describes open treatment of a bicondylar proximal tibial plateau fracture. Use 29856 for arthroscopically assisted fixation of a plateau fracture.
No office rate
This arthroscopically assisted fracture code is for intercondylar spine or tuberosity fractures of the knee, not a proximal tibial plateau fracture.
Compare 29856 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
$865.31
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 29856 in Vermont.
PPRRVU2026_Oct_nonQPP.csv
3,345
- Code
- 29856
- Physician work
- 13.92
- Practice expense
- 10.59
- Malpractice
- 2.97
GPCI2026.csv
105
- Locality
- Vermont
- Physician work
- 1.000
- Practice expense
- 0.990
- Malpractice
- 0.506
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 13.92 | × 1.000 | 13.9200 |
| Practice expense | 10.59 | × 0.990 | 10.4841 |
| Malpractice | 2.97 | × 0.506 | 1.5028 |
| Total RVUs | 25.9069 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Vermont$865.31
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 13.92 | 1 |
| Practice expense | 10.59 | 0.99 |
| Malpractice | 2.97 | 0.506 |
(13.92 × 1 + 10.59 × 0.99 + 2.97 × 0.506) × $33.4009 = $865.31
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.
29856 billing questions
How does this differ from 29855?
Both codes address arthroscopically assisted treatment of a proximal tibial plateau fracture. Use 29856 when internal fixation is performed; 29855 is for treatment without internal fixation.
Can diagnostic arthroscopy be billed separately?
No. The arthroscopy used for this fracture treatment is included in 29856.
What documentation supports 29856?
The operative report should identify the proximal tibial plateau fracture and describe arthroscopic assistance, fracture reduction, and the internal fixation performed.
How does the 90-day global period affect postoperative billing?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
How is bilateral reporting handled?
When the procedure is performed bilaterally and reported with modifier 50, CMS pays 150% under the stated bilateral rule.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid, and co-surgeons are permitted. 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.
3,34229850,,Knee arthroscopy/surgery,A,,8.06,8.00,NA,8.00,,1.71,17.77,17.77,0,090,0.10,0.69,0.21,2,1,0,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,34329851,,Knee arthroscopy/surgery,A,,12.93,10.12,NA,10.12,,2.75,25.80,25.80,0,090,0.10,0.69,0.21,2,1,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,34429855,,Tibial arthroscopy/surgery,A,,10.49,9.20,NA,9.20,,2.16,21.85,21.85,0,090,0.10,0.69,0.21,2,1,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,34529856,,Tibial arthroscopy/surgery,A,,13.92,10.59,NA,10.59,,2.97,27.48,27.48,0,090,0.10,0.69,0.21,2,1,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,34629860,,Hip arthroscopy dx,A,,8.78,7.95,NA,7.95,,1.69,18.42,18.42,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,34729861,,Hip arthro w/fb removal,A,,9.85,8.01,NA,8.01,,1.82,19.68,19.68,0,090,0.10,0.69,0.21,3,1,2,1,0,9,29860,33.4009,09,0,99,0.00,0.00,0.00
3,34829862,,Hip arthr0 w/debridement,A,,10.89,9.69,NA,9.69,,2.17,22.75,22.75,0,090,0.10,0.69,0.21,3,1,2,1,0,9,29860,33.4009,09,0,99,0.00,0.00,0.00
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