Open treatment of proximal fibula or shaft fracture

CPT 27784 is the billing code for "Open treatment of proximal fibula or shaft fracture". For open treatment of proximal fibula or shaft fracture

Medicare pays approximately $703.86 for CPT 27784 (national average). Actual payment varies by geographic location due to GPCI adjustments. Hospital and commercial insurance rates are typically 2-4x higher than Medicare rates.

CPT 27784 has a total RVU of 33.15, broken down as: Work RVU 14.50, Practice Expense RVU 17.20, and Malpractice RVU 1.45. RVUs (Relative Value Units) determine Medicare reimbursement rates.

Key documentation requirements for CPT 27784 include: Indication for open treatment; Fracture type and location; Surgical approach; Hardware used. Missing or incomplete documentation is a leading cause of claim denials for this code.

Bundling considerations for CPT 27784: Includes open treatment. Includes internal fixation Use an NCCI bundling checker to verify specific code combinations before billing.

Common modifiers for CPT 27784 include: 50 (Bilateral procedure when both legs performed same session), 51 (Multiple procedures performed same session), 22 (Increased procedural services for complex cases). Modifiers indicate special circumstances and can affect reimbursement or prevent claim denials.

The typical time requirement for CPT 27784 is 60-90 minutes typical operative time. Time-based codes require documentation of the actual time spent providing the service.