CPT code 27236: Femoral neck repair, open fixation or replacement2026 Medicare rate & RVUs

Medicare pays $1,089.87 for 27236 nationally in a facility.

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 27236 covers

This code describes open surgery for a fracture through the femoral neck, the part of the thigh bone connecting its head to the shaft. The orthopedic surgeon exposes the fracture and treats it with internal fixation or replaces the fractured portion with a prosthesis. It is commonly performed in a hospital operating room for patients whose femoral neck fracture requires this open approach and treatment; it is distinct from percutaneous fixation and closed fracture care.

Select the code when the operative report supports the femoral neck location, open exposure, and fixation or prosthetic replacement. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. When other procedures are performed in the same session, the highest-valued procedure is paid in full and the others at 50%. For bilateral reporting with modifier 50, CMS pays at 150%. An assistant at surgery may be paid; co-surgeons are paid only with supporting documentation, and team surgery is not permitted.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

Where 27236 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

27236 rates by state

Office rate range in each state. Select a state to see its payment localities.

How the 27236 rate is calculated

Each of 27236’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

Payment rules and modifiers for 27236

27236 has a 90-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 50

27236 compared with similar codes

How to choose

27235Fracture fixationPercutaneous femoral neck fixation

Choose 27236 for open treatment of a femoral neck fracture with fixation or prosthetic replacement. Choose 27235 for percutaneous skeletal fixation.

27230Fracture treatmentFemoral neck, closed

27230 describes closed treatment of a femoral neck fracture without manipulation, rather than open fixation or replacement.

27232Fracture treatmentWith manipulation, with or without traction

27232 describes closed treatment of a femoral neck fracture with manipulation; 27236 requires open operative treatment.

27244Femur fracture repairPlate or screw fixation

27244 is for plate-and-screw treatment of an intertrochanteric, pertrochanteric, or subtrochanteric fracture, not a femoral neck fracture.

Codes related to 27236

Related codes aren’t interchangeable: bill the code that matches the service performed.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Open CMS sourceHow we calculate rates