CPT 27215
Global 090Treat pelvic fracture(s)
CPT 27215 Billing & Documentation Guide
CPT code 27215 (Treat pelvic fracture(s)) is classified under Surgery (Musculoskeletal) with a global period indicator of 090. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 10.19, a non-facility practice expense RVU of 4.92, and a malpractice RVU of 1.09, a total non-facility RVU of 16.2 and facility RVU of 16.2. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $549.98, though rates vary from $500.27 to $705.61 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 27215, ensure documentation supports medical necessity and the specific components required for the code's level of service. For E/M codes, document MDM (medical decision-making) elements: problems addressed, data reviewed, and risk. For procedural codes, document the indication, technique, and any complications. Always verify NCCI edits before bundling 27215 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Invalid for Medicare; not separately payable
90-day global period (major surgery: 1 day pre-op + procedure + 90 days post-op)
MUE Limit (Medically Unlikely Edits)
Submitting more than 0 units of 27215 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.
RVU Breakdown, CPT 27215
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 10.19 | 10.19 |
| Practice Expense RVU | 4.92 | 4.92 |
| Malpractice RVU | 1.09 | 1.09 |
| Total RVU | 16.2 | 16.2 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 27215
State-level averages across all MAC localities. Non-facility rates typically apply to office-based services; facility rates apply to hospital outpatient / inpatient.
| State | Non-Facility | Facility | Range (Non-Fac) | Localities |
|---|---|---|---|---|
| California | $566.74 | $566.74 | $545.76 - $634.28 | 29 |
| Florida | $576.11 | $576.11 | $552.18 - $603.5 | 3 |
| Georgia | $541.2 | $541.2 | $530.34 - $552.06 | 2 |
| Illinois | $569.91 | $569.91 | $547.29 - $591.45 | 4 |
| Michigan | $545.91 | $545.91 | $531.49 - $560.32 | 2 |
| North Carolina | $516.94 | $516.94 | $516.94 - $516.94 | 1 |
| New York | $589.32 | $589.32 | $522.07 - $625.14 | 5 |
| Ohio | $527.09 | $527.09 | $527.09 - $527.09 | 1 |
| Pennsylvania | $543.31 | $543.31 | $525.62 - $560.99 | 2 |
| Texas | $537.83 | $537.83 | $523.72 - $556.36 | 8 |
Source: CMS PFSRVU 2026 · Updated 2026-04-01. Full locality-level detail available for all 53 states, contact us for custom reports.
NCCI Bundling Edits, CPT 27215
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 27215 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 01995 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 0708T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0709T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0903T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0904T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0905T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 12001 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 12002 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 12004 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 12005 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
Frequently Asked Questions, CPT 27215
What does CPT code 27215 mean? +
CPT code 27215 represents: Treat pelvic fracture(s). It's in the Surgery (Musculoskeletal) category with a global period of 090.
What is the Medicare reimbursement for CPT 27215? +
The 2026 Medicare national average non-facility payment for CPT 27215 is $549.98. Rates range from $500.27 to $705.61 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 27215? +
Surgery codes commonly use modifier 22 (increased procedural services), 50 (bilateral), 51 (multiple procedures), 52 (reduced services), 58/78/79 (staged, unplanned return, unrelated within global), 62 (co-surgeons), 80/82 (assistant surgeon), and 59 or the X{EPSU} subset for distinct procedural service.
What bundling edits apply to CPT 27215? +
This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
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