Closed treatment of a patellar fracture without manipulation — immobilization only, no bone repositioning or surgical fixation.

Verified May 8, 2026 · 7 sources ↓

Medicare: $369.75
Total RVUs: 11.07
Global, days: 90
Region: Knee

Drawn from CMSAAPCGenhealthMdclarityAcgme

Documentation requirements

What must appear in the operative or office note to support the claim.

Source · Editorial brief grounded in 7 cited references ↓

Imaging report (X-ray at minimum) confirming non-displaced patellar fracture — document specific fracture pattern and displacement measurement
Explicit statement that no manipulation was performed and no surgical reduction was required
Type of immobilization device applied (cast, splint, or brace) and laterality (left or right knee)
Documentation that the treating physician is assuming ongoing fracture care and follow-up through the global period
ICD-10 fracture code with laterality and encounter type (initial care = 'A' suffix, subsequent = 'D' suffix, sequela = 'S')
Physical examination findings supporting non-operative management, including neurovascular status of the extremity

Applicable modifiers

Modifiers commonly billed with this code.

Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual

22 Increased complexity 24 Unrelated E/M during global 50 Bilateral procedure 51 Multiple procedures 58 Staged or related 76 Repeat, same physician 78 Unplanned return — related 79 Unrelated during global LT Left side RT Right side

What this code covers

Source · Editorial summary grounded in 7 cited references ↓

CPT 27520 covers closed, non-manipulative treatment of a patellar fracture. The fracture fragments are not repositioned; the treating physician applies a cast, splint, or brace to immobilize the knee and allow the bone to heal in place. This is appropriate for non-displaced or minimally displaced patellar fractures confirmed on imaging where surgical intervention is not indicated.

The 90-day global period starts on the date fracture care is assumed. That window includes the day-before visit (if applicable), the initial treatment encounter, and all routine follow-up visits through day 90 — including cast checks, splint adjustments, and wound care. Casting and splinting are bundled per NCCI; you cannot bill separate cast application codes when you are also billing 27520 and assuming follow-up care. If only an E/M and cast application are provided with no assumption of ongoing fracture care, bill those separately instead.

If the fracture is displaced and requires manipulation to reduce, 27520 is the wrong code — step up to the appropriate manipulative closed treatment code. If open treatment with internal fixation becomes necessary, 27524 is the correct code. Payers will scrutinize operative notes and imaging reports to confirm the non-displaced, non-surgical nature of the encounter, so documentation must be unambiguous.

RVU & reimbursement

Component RVUs and Medicare national rate. Actual payment varies by GPCI locality.

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU	2.96
Practice expense RVU	7.5
Malpractice RVU	0.61
Total RVU	11.07
Medicare national rate	$369.75
Global period	90 days

Payment by site of service

Medicare pays different rates by setting. HOPD typically pays substantially more than ASC for the same procedure.

Source · CMS OPPS Addendum B·ASC HCPCS payment rates·2026

Setting	Medicare rate (national)
Office (PFS non-facility) Procedure performed in physician's office	$369.75
HOPD (APC 5111) Hospital outpatient department	$252.01
ASC (PI A2) Ambulatory surgical center (freestanding)	$135.54

Common denial reasons

The recurring reasons claims for CPT 27520 get rejected.

Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓

Missing laterality on the claim — append LT or RT; bilateral cases require modifier 50
Separate cast or splint application code billed alongside 27520 when the same physician assumes follow-up care — NCCI bundles these
Fracture described as displaced or manipulated in the operative/clinical note but billed under 27520, triggering medical necessity denial or downcoding
E/M service billed on the same date as fracture care assumption without modifier 25 to document a significant, separately identifiable service
Follow-up visits billed without modifier 24 when they fall within the 90-day global and are related to the patellar fracture

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 7 cited references ↓

01What's the difference between 27520 and 27522?

27520 is closed treatment without manipulation — immobilization only. 27522 is closed treatment with manipulation, meaning the physician actively repositioned the fracture fragments. If you manipulated, 27520 is the wrong code.

02Can I bill a cast application code separately when I also bill 27520?

No. When you bill 27520 and assume follow-up fracture care, casting and splinting are bundled per NCCI. Bill them separately only if you apply a cast or splint as the sole initial service and are not assuming ongoing fracture care — in that case, bill the E/M and cast code instead of 27520.

03How do I bill bilateral patellar fractures treated the same day?

Use 27520-50 for bilateral billing, or bill two lines with 27520-LT and 27520-RT. Do not append modifier 59 to the second unit — that's the wrong bilateral modifier for this scenario.

04If the patient later needs open fixation, how does that affect the global period?

Open treatment (27524) performed after 27520 within the 90-day global is a staged or related procedure. Append modifier 58 to 27524 to break out of the 27520 global period and establish a new one.

05Does 27520 have a 90-day global, and what does that cover?

Yes — 90-day global. It covers the day-before visit, the treatment date, and all routine post-fracture follow-up through day 90, including cast checks and splint changes. Any E/M visit unrelated to the patella fracture in that window needs modifier 24.

06What ICD-10 code pairs with 27520?

Use S82.0xx codes (patellar fracture) with the appropriate laterality character and the 'A' encounter suffix for initial active treatment. Payers will flag a 'D' (subsequent encounter) suffix paired with the initial fracture care code.

Sources & references

Editorial content was developed using the following public sources. Last verified May 8, 2026.

Mira AI Scribe

Mira's AI scribe captures fracture displacement status, imaging findings, immobilization device type and laterality, and the physician's explicit decision not to manipulate — directly from dictation. That documentation locks in the correct code selection between 27520 and its manipulative or open-treatment alternatives, preventing the most common audit flag: a note that describes a displaced fracture billed under a non-manipulative code.

See how Mira captures CPT 27520 documentation