Closed treatment of a tibial shaft fracture without manipulation, applied when the fracture is nondisplaced or stable enough to maintain alignment without manual reduction.

Verified May 8, 2026 · 6 sources ↓

Medicare: $395.47
Total RVUs: 11.84
Global, days: 90
Region: Foot & ankle

Drawn from CMSAAPCMdclarityPayerpriceAAOS

Documentation requirements

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

Source · Editorial brief grounded in 6 cited references ↓

Explicit statement that no manipulation was performed to achieve fracture alignment
Imaging findings confirming nondisplaced or minimally displaced tibial shaft fracture
Notation of whether a fibular fracture is also present (does not change the code but should be documented)
Type and application of immobilization device used (cast, splint, brace) with clinical rationale
Neurovascular status of the affected extremity at time of treatment
Laterality documented — left or right tibia — to support LT/RT modifier use

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 25 Significant separate E/M 50 Bilateral procedure 51 Multiple procedures 57 Decision for surgery 58 Staged or related 76 Repeat, same physician 77 Repeat, another physician 78 Unplanned return — related 79 Unrelated during global LT Left side RT Right side

What this code covers

Source · Editorial summary grounded in 6 cited references ↓

CPT 27750 covers closed treatment of a tibial shaft fracture — with or without an associated fibular fracture — where no manipulation is required to achieve acceptable alignment. The fracture is managed conservatively, typically with casting or splinting, to immobilize the tibia, prevent displacement, and allow healing. Because no reduction maneuver is performed, this code sits one step below 27752, which covers the same fracture treated with manipulation.

The 90-day global period means all routine fracture follow-up, cast changes, wound checks, and removal of immobilization are bundled through day 90. Bill an E/M in that window only if it addresses a problem genuinely unrelated to the fracture — and append modifier 24. If a decision for surgery is made during a same-day E/M, use modifier 57.

Code selection hinges on whether manipulation occurred. If the operative or clinical note documents any reduction attempt, 27750 is wrong — 27752 applies. Auditors look for that distinction specifically, so the documentation must state clearly that the fracture required no manipulation to achieve alignment.

RVU & reimbursement

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

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU	3.29
Practice expense RVU	7.87
Malpractice RVU	0.68
Total RVU	11.84
Medicare national rate	$395.47
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	$395.47
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 27750 get rejected.

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

Code mismatch: fracture described as displaced or reduced in notes but 27750 billed instead of 27752
Missing imaging documentation to support the nondisplaced fracture diagnosis and conservative management decision
E/M billed same-day during global period without modifier 24 or 25 to establish medical necessity for a separate service
Laterality modifier absent when payer requires LT or RT for unilateral procedures
Insufficient documentation distinguishing tibial shaft fracture from a more distal tibia or plateau fracture, causing ICD-10 mismatch

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 6 cited references ↓

01What's the difference between 27750 and 27752?

27750 is for closed treatment without manipulation — the fracture is acceptably aligned and no reduction is needed. 27752 covers the same fracture when manipulation or skeletal traction is required to achieve alignment. If your note describes any reduction attempt, bill 27752.

02Can I bill a casting or strapping code separately with 27750?

No. Application of the initial cast or splint is included in the fracture care code. Separate cast application codes (e.g., 29405, 29425) are bundled into 27750 and will be denied as duplicate billing.

03What ICD-10 codes pair with 27750?

Use S82.2x-series codes for tibial shaft fractures. Specify nondisplaced (S82.201A initial encounter, for example) and confirm the fracture sub-type and laterality match what's documented in the radiology report and clinical note.

04How does the 90-day global period affect post-fracture E/M visits?

All routine fracture follow-up through day 90 is bundled — casting checks, alignment x-rays, and immobilization changes are not separately billable. If a visit addresses an unrelated condition, use modifier 24 on the E/M. Without modifier 24, the claim will likely deny.

05Is 27750 ever billed bilaterally?

Bilateral tibial shaft fractures are uncommon but possible (high-energy trauma). If both tibias are treated on the same date, bill with modifier 50 for professional claims. In an ASC setting, bill two separate lines using LT and RT per CMS NCCI bilateral billing rules.

06When would modifier 58 apply to 27750?

Use modifier 58 if the initial conservative management was planned as a first stage and the patient is returning within the global period for a related subsequent procedure — for example, if a nondisplaced fracture later requires surgical fixation that was anticipated. Modifier 58 resets the global clock. Don't use it for unplanned returns due to complications; that's modifier 78.

Sources & references

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

Mira AI Scribe

Mira's AI scribe captures the key decision point for 27750 automatically: whether manipulation was attempted and whether the fracture was nondisplaced on imaging. It pulls laterality, immobilization type, and neurovascular findings from dictation and flags the note if a reduction maneuver is mentioned — preventing the single most common audit finding on this code, which is billing 27750 when the clinical narrative actually describes a 27752.

See how Mira captures CPT 27750 documentation