No office rate
Choose 27535 for a unicondylar plateau fracture treated operatively; 27536 describes operative treatment of a bicondylar plateau fracture.
On this page
CMS RVU26D · Effective 2026-10-01
27535 Tibial plateau fracture Medicare reimbursement rates in Virginia
Open operative treatment of a unicondylar proximal tibial plateau fracture, with internal fixation included when performed, is reported for the affected knee. Compare 27535 office and facility rates across CMS payment localities in Virginia.
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 27535 in Virginia?
Virginia has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$783.43–$900.34
2 of 2 localities have a supported rate.
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 27535: Open unicondylar tibial plateau fracture treatment
Open operative treatment of a unicondylar proximal tibial plateau fracture, with internal fixation included when performed, is reported for the affected knee.
This service covers operative treatment of a fracture involving one condyle of the proximal tibial plateau. An orthopedic surgeon typically performs it in an operating room, exposing and treating the fracture; internal fixation is included when used. It is distinct from surgery for a bicondylar plateau fracture and from treatment of tibial spine or tuberosity fractures.
Report the code when the operative record supports open treatment and identifies the fracture as unicondylar. Document the affected side, fracture anatomy, operative approach, and fixation performed. CMS assigns a 90-day global period, including 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 and co-surgeon services may be paid; team surgery is not permitted.
CMS billing rules for 27535
- 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 RVU13.07 · 54%
- Practice expense (office) RVU8.59 · 35%
- Malpractice RVU2.75 · 11%
3.1K
Medicare services in 2024 · #2153 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.
27535 compared with similar codes
Office rates for Virginia, from the same CMS release.
$339.67–$399.33
27530 is for closed treatment of a proximal tibial plateau fracture without manipulation. This code is for open operative treatment.
$657.43–$766.08
27532 describes closed treatment of a proximal tibial plateau fracture with manipulation; it is not the open operative service represented here.
No office rate
27540 concerns operative treatment of a tibial spine or knee tuberosity fracture. This code is for a unicondylar proximal tibial plateau fracture.
Compare 27535 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.
2 of 2 payment localities
Dc + Md/Va Suburbs →
Office / nonfacility
Unavailable
Facility
$900.34
Virginia →
Office / nonfacility
Unavailable
Facility
$783.43
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.
27535 billing questions
How is this code distinguished from 27536?
This code is for open treatment of a unicondylar tibial plateau fracture. Use 27536 when the plateau fracture is bicondylar.
Can internal fixation be billed separately?
Internal fixation, when performed as part of this fracture treatment, is included in the service. The operative report should describe the fixation and fracture treatment.
How does this differ from 27530 or 27532?
Those codes describe closed treatment of a proximal tibial plateau fracture. This code applies when the fracture is treated operatively through an open approach.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How are additional procedures in the same session paid?
The highest-valued procedure is paid in full; other procedures are subject to the standard multiple-procedure reduction, with payment at 50%.
May an assistant or co-surgeon be reported?
CMS permits payment for an assistant at surgery and for co-surgeons. Team surgery is not permitted for this code.
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.
2,93827524,,Treat kneecap fracture,A,,10.11,8.89,NA,8.89,,2.11,21.11,21.11,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,93927530,,Treat knee fracture,A,,2.58,7.34,,5.90,,0.53,10.45,9.01,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,94027532,,Treat knee fracture,A,,7.36,11.43,,7.74,,1.54,20.33,16.64,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,94127535,,Treat knee fracture,A,,13.07,8.59,NA,8.59,,2.75,24.41,24.41,0,090,0.10,0.69,0.21,2,1,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,94227536,,Treat knee fracture,A,,16.96,12.10,NA,12.10,,3.60,32.66,32.66,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,94327538,,Treat knee fracture(s),A,,4.96,10.11,,7.47,,1.06,16.13,13.49,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,94427540,,Treat knee fracture,A,,11.02,9.48,NA,9.48,,2.33,22.83,22.83,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00