CPT code 27238: Femoral fracture care, without manipulation2026 Medicare rate & RVUs

Medicare pays $457.59 for 27238 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 27238 covers

This code describes closed management of a fracture through the femoral shaft without manipulating the fracture fragments. An orthopedic surgeon or other qualified physician may use this approach when the fracture can be managed without operative fixation, maintaining alignment with appropriate nonoperative care such as immobilization or traction. Treatment may occur in a hospital or another setting where the physician establishes and directs the fracture-care plan.

Select the code when documentation supports a femoral shaft fracture and confirms treatment without manipulation; distinguish it from care involving manipulation or surgical fixation. The record should identify the fracture site, treatment plan, and whether the fragments were manipulated. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Medicare does not pay an assistant at surgery; co-surgeons and team surgery are 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 27238 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

27238 rates by state

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

How the 27238 rate is calculated

Each of 27238’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 27238

27238 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

27238 compared with similar codes

How to choose

27240Femoral fracture careNeck fracture, with manipulation

Both address closed treatment of a femoral shaft fracture; 27240 involves manipulation, while 27238 does not.

27244Femur fracture repairPlate or screw fixation

Use 27244 for open treatment of a femoral shaft fracture, not closed treatment without manipulation.

27245Femur fracture fixationIntramedullary implant

Use 27245 when the femoral shaft fracture is treated with an intramedullary implant.

27230Fracture treatmentFemoral neck, closed

Code 27230 concerns a femoral neck fracture treated without manipulation; 27238 is for the femoral shaft.

Codes related to 27238

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