Closed treatment of a tibial shaft fracture requiring manual realignment, with or without an accompanying fibular fracture and with or without skeletal traction — no incision made.

Verified May 8, 2026 · 6 sources ↓

Medicare: $608.23
Total RVUs: 18.21
Global, days: 90
Region: Foot & ankle

Drawn from CMSAAPCFindacodeFastrvu

Documentation requirements

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

Source · Editorial brief grounded in 6 cited references ↓

Explicit fracture location — 'tibial shaft' must be documented, not just 'tibia' or 'distal tibia'
Confirmation that reduction was performed by manipulation (closed technique, no incision)
Documentation of whether skeletal traction was applied and the method used
Notation of fibular fracture presence or absence; if present, confirm it was not independently treated
Pre- and post-reduction radiographic findings demonstrating fracture alignment
Anesthesia type used (local, regional, general, or none) if applicable to support medical necessity

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 52 Reduced services 57 Decision for surgery 58 Staged or related 59 Distinct service 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 27752 covers closed (non-operative) manipulation of a tibial shaft fracture. The surgeon manually reduces the fracture — restoring alignment without an incision — and may apply skeletal traction to maintain position while healing progresses. If a fibular fracture is also present, it is not treated separately under this code; its incidental presence does not change the code selection.

Shaft location is the critical determinant here. Distal tibial fractures involving the ankle joint or the weight-bearing articular surface are not reported with 27752 — those map to 27810 or 27825 depending on anatomy. When the operative note describes a 'distal tibia/fibula' fracture, verify with the surgeon whether the fracture involves the malleoli or the pilon before coding.

The 90-day global period covers the manipulation, casting, and all routine follow-up visits through day 90. Separate E/M services during that window require modifier 24 (unrelated) or 25 (significant, separately identifiable, same-day decision-making). Cast changes and routine traction management are bundled into the global — they are not separately billable.

RVU & reimbursement

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

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU	6.11
Practice expense RVU	10.76
Malpractice RVU	1.34
Total RVU	18.21
Medicare national rate	$608.23
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	$608.23
HOPD (APC 5112) Hospital outpatient department	$1,642.82
ASC (PI A2) Ambulatory surgical center (freestanding)	$872.87

Common denial reasons

The recurring reasons claims for CPT 27752 get rejected.

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

Wrong code selected — distal tibial or malleolar fractures billed as 27752 instead of 27810 or 27825
Separate billing for fibular fracture treatment when no independent fibular procedure was performed
E/M visit billed during the 90-day global without modifier 24 or 25, triggering global period bundling denial
Lack of imaging documentation to support medical necessity of manipulation
Laterality modifier missing when payer requires LT or RT for unilateral procedures

Frequently asked questions

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

01Can 27752 be billed if a fibular fracture is also present?

Yes. The code explicitly covers tibial shaft fractures with or without an accompanying fibular fracture. If the fibular fracture is not independently treated, no separate fibula fracture code is added.

02What is the global period for 27752, and what does it include?

27752 carries a 90-day global. The pre-operative day, the procedure, and all routine follow-up — including cast checks, traction management, and suture removal — are bundled through day 90. Separate billing in that window requires modifier 24 or 25.

03When should I use 27810 or 27825 instead of 27752?

Use 27810 for bimalleolar ankle fractures involving the distal fibula. Use 27825 when the distal tibia fracture involves the weight-bearing articular surface (pilon/tibial plafond). 27752 is limited to the tibial shaft — confirm fracture location with the surgeon before coding any 'distal tibia' diagnosis.

04Is modifier 50 appropriate for 27752?

Bilateral tibial shaft fractures are rare, but if both tibiae are manipulated in the same session, modifier 50 applies. Most payers require a single line with modifier 50; some require two lines with LT and RT. Check your payer's bilateral surgery policy first.

05Can an E/M be billed the same day as 27752?

Yes, but only if the E/M represents a significant, separately identifiable service beyond the fracture management decision — apply modifier 25. If the E/M is the visit where the decision to treat the fracture was made, modifier 57 is used when the procedure has a 90-day global.

06Does 27752 require traction to be billed?

No. The code description covers manipulation with or without skeletal traction. Traction use should still be documented in the operative note, but its absence does not change the code selection.

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 fracture location (shaft vs. distal tibia), the closed manipulation technique, traction use, fibular fracture status, and post-reduction alignment from the surgeon's dictation. This prevents the most common 27752 audit flag — operative notes that document 'tibia fracture' without specifying shaft location, which auditors use to question whether 27752 or a distal/malleolar code was correct.

See how Mira captures CPT 27752 documentation