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CPT code 27245: Femur fracture fixation, intramedullary implant2026 Medicare rate & RVUs

Reports operative fixation of an intertrochanteric, peritrochanteric, or subtrochanteric femoral fracture using an intramedullary implant.

CMS RVU26DEffective Oct 1, 2026109 payment localities94.7K Medicare services in 2024

Medicare pays $1,118.26 for 27245 nationally in a facility.

Medicare rate · 27245

Femur fracture fixation, intramedullary implant

Office or facility?

Work RVUs
17.73
Total RVUs
33.48
Global days
090

National rate · 2026

$1,118.26

Facility setting, before claim adjustments.

See every locality for 27245 →Billed by an NP, PA or therapist? →

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

Your location

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What 27245 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 27245 covers

An orthopedic surgeon uses an intramedullary implant to stabilize a fracture in the upper femur, such as an intertrochanteric or subtrochanteric fracture. The implant is placed through the proximal femur and extends into the bone’s medullary canal; interlocking screws or cerclage may also be used. This procedure is commonly performed in a hospital operating room for patients whose fracture pattern and treatment plan call for operative stabilization.

Select this code when the operative report supports the specified fracture region and intramedullary fixation method; the implant and operative details distinguish it from plate-and-screw fixation or closed treatment. The service has 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%. Assistant-at-surgery payment and co-surgeons are permitted; 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 27245 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

27245 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$1,014.21
AlaskaUnavailable$1,384.86
ArizonaUnavailable$1,087.95
ArkansasUnavailable$1,001.46
Atlanta, GAUnavailable$1,151.38
Austin, TXUnavailable$1,128.64
Bakersfield, CAUnavailable$1,119.67
Baltimore area, MDUnavailable$1,186.46
Beaumont, TXUnavailable$1,073.27
Brazoria, TXUnavailable$1,092.12

27245 rates by state

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

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Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

View every state and territory as a table
27245 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 27245 rate is calculated

Each of 27245’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.

How the rate is built · 27245

RVUs × geographic indexes × conversion factor

Office or facility?

Work17.73

17.73 RVUs× 1.000 GPCI

Practice expense12.04

12.04 RVUs× 1.000 GPCI

Malpractice3.71

3.71 RVUs× 1.000 GPCI

Adjusted RVUs

33.4800

Conversion factor

$33.4009

Medicare rate

$1,118.26

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 27245

27245 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 27245

Femur fracture fixation, intramedullary implant

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
Assistant at surgery (80/81/82/AS)2Paid.
Co-surgeons (62)2Permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.69/0.21Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 27245

Femur fracture fixation, intramedullary implant

90-day global period ends

Dec 30, 2026

Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).

Visit on Oct 31, 2026

Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 50 · payment effect

With and without the modifier

27245 without 50 · national facility

$1,118.26

Femur fracture fixation, intramedullary implant

27245-50 · Bilateral: 150%

$1,677.39

Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).

When to use modifier 50

27245 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 27245

    Femur fracture fixation, intramedullary implant17.73 wRVU

    Not priced

  • 27244

    Femur fracture repair, plate or screw fixation17.73 wRVU

    Not priced

  • 27240

    Femoral fracture care, neck fracture, with manipulation13.46 wRVU

    Not priced

  • 27236

    Femoral neck repair, open fixation or replacement17.17 wRVU

    Not priced

How to choose

27244Femur fracture repairPlate or screw fixation
Use 27245 when the fracture is stabilized with an intramedullary implant. Use 27244 when the documented fixation uses a plate-and-screw type implant.
27240Femoral fracture careNeck fracture, with manipulation
This code reports operative intramedullary fixation. Code 27240 describes closed treatment of an intertrochanteric, peritrochanteric, or subtrochanteric fracture.
27236Femoral neck repairOpen fixation or replacement
Code 27236 is for open treatment of a femoral neck fracture. Code 27245 applies to specified intertrochanteric, peritrochanteric, or subtrochanteric fractures treated with an intramedullary implant.

Codes related to 27245

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

Codes related to 27245
CodeHow it relatesNational office range
Same family
27244Femur fracture repair, plate or screw fixationTreats the same proximal femoral fracture patterns using plate-and-screw type fixation.No office rate
27240Femoral fracture care, neck fracture, with manipulationAddresses intertrochanteric, peritrochanteric, or subtrochanteric fracture treatment without the open fixation described here.No office rate
27238Femoral fracture care, without manipulationCovers closed treatment of a femoral shaft fracture, a different femoral fracture site and treatment approach.No office rate

27245 billing questions

How does this differ from code 27244?

Both address intertrochanteric, peritrochanteric, or subtrochanteric fractures. Report 27245 for intramedullary implant fixation and 27244 when the operative method uses a plate-and-screw type implant.

Can this code be used for a femoral neck fracture?

No. This code is for specified proximal femoral fracture patterns outside the femoral neck; select a femoral-neck treatment code when that is the documented fracture site.

Are related postoperative visits included?

Yes. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.

How is bilateral surgery reported?

For bilateral procedures, report modifier 50; CMS pays the procedure at 150%.

Can an assistant or co-surgeon be reported?

Assistant-at-surgery payment may be made, and co-surgeons are permitted. Team surgery is not permitted for this code.

What happens when another procedure is performed in the same session?

Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and the other procedure or procedures are paid at 50%.

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

Show the CMS file lines behind this rate
RVUs for 27245PPRRVU2026_Oct_nonQPP.csv, line 2,802 (RVU26D)

Open CMS sourceHow we calculate rates

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