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CPT code 27500: Femur fracture care, shaft, no manipulation2026 Medicare rate & RVUs in Iowa

Reports closed management of a femoral shaft fracture when the provider treats it without manipulating or reducing the fracture.

CMS RVU26DEffective Oct 1, 2026One payment locality421 Medicare services in 2024

In Iowa, Medicare pays $520.43 for 27500 in the office and $420.19 when it’s performed in a hospital or facility.

$520.43Office (non-facility)
$420.19Hospital or facility
−9.4%vs the national office rate ($574.50)

Check a contract rate as a % of Medicare · 27500 nationwide

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

We’ll open 27500 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Iowa
  2. What 27500 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 27500 covers

This code describes closed management of a fracture through the shaft of the femur when the provider does not manipulate the fracture to change its alignment. An orthopedic surgeon or other qualified physician may provide this care in a hospital or outpatient setting when the fracture can be managed without a reduction. The treatment plan may include immobilization and follow-up to monitor healing; the record should identify the fracture’s shaft location and the closed-treatment approach.

Report the code when documentation supports treatment without manipulation, rather than reduction or operative fixation. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures are paid at 50%. For bilateral treatment reported with modifier 50, CMS pays at 150%. CMS does not pay an assistant at surgery for this code; 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.

How Iowa compares for 27500

Across 109 of 109 payment localities, the office rate for 27500 runs from $507.36 in Arkansas to $720.69 in San Benito County, CA. Iowa pays $520.43. The RVUs are the same everywhere; the geographic indexes change the dollars.

27500 in Iowa vs other payment areas
  1. Iowa · this page$520.43
  2. Los Angeles, CA · California$627.80+$107.37
  3. Washington, DC area · District of Columbia$648.48+$128.05
  4. Miami, FL · Florida$654.75+$134.32
  5. Chicago, IL · Illinois$634.22+$113.79
  6. Manhattan, NY · New York$666.02+$145.59
  7. Alaska · Alaska$678.56+$158.13

Other areas in Iowa first, then benchmark localities. Bars start at $0.

Every other payment area

27500 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$514.80$418.94
ArkansasArkansas$507.36$413.25
ArizonaArizona$558.10$451.94
Bakersfield, CACalifornia$592.55$472.47
Chico, CACalifornia$588.94$468.87
El Centro, CACalifornia$589.16$469.09
Fresno, CACalifornia$588.94$468.87
Hanford, CACalifornia$588.94$468.87

27500 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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.

$507.36

$678.56

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
27500 office rate range by state
State / territoryOffice rate rangeLocalities
AK$678.561
AL$514.801
AR$507.361
AZ$558.101
CA$588.94–$720.6929
CO$588.221
CT$612.861
DC$648.481
DE$567.191
FL$582.18–$654.753
GA$547.73–$589.122
GU$600.691
HI$600.691
IA$520.431
ID$525.381
IL$570.80–$634.224
IN$528.231
KS$521.531
KY$534.631
LA$535.21–$561.232
MA$586.15–$641.272
MD$576.87–$648.483
ME$531.90–$555.422
MI$551.81–$593.112
MN$553.141
MO$528.42–$558.953
MS$517.811
MT$574.411
NC$536.881
ND$548.501
NE$522.201
NH$582.381
NJ$616.90–$642.502
NM$556.261
NV$567.511
NY$545.22–$686.675
OH$546.511
OK$529.891
OR$560.20–$602.722
PA$545.38–$599.982
PR$577.421
RI$584.411
SC$543.181
SD$545.441
TN$524.601
TX$542.08–$590.318
UT$550.491
VA$556.10–$648.482
VI$577.421
VT$549.621
WA$583.96–$650.672
WI$530.541
WV$550.691
WY$563.121

See 27500 in every payment locality

How the 27500 rate is calculated

Each of 27500’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 · 27500

RVUs × geographic indexes × conversion factor

Office or facility?

Work6.14

6.14 RVUs× 1.000 GPCI

Practice expense9.75

9.75 RVUs× 1.000 GPCI

Malpractice1.31

1.31 RVUs× 1.000 GPCI

Adjusted RVUs

17.2000

Conversion factor

$33.4009

Medicare rate

$574.50

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

The exact Iowa inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

2,922

Code
27500
Physician work
6.14
Practice expense
9.75
Malpractice
1.31

GPCI2026.csv

53

Locality
Iowa
Physician work
1.000
Practice expense
0.915
Malpractice
0.397
Office calculation for 27500 in Iowa
ComponentRVULocality factorAdjusted
Physician work6.14× 1.0006.1400
Practice expense9.75× 0.9158.9213
Malpractice1.31× 0.3970.5201
Total RVUs15.5813
Conversion factor× 33.4009

Office rate, Iowa$520.43

Office: (6.14 × 1 + 9.75 × 0.915 + 1.31 × 0.397) × $33.4009 = $520.43

Facility: (6.14 × 1 + 6.47 × 0.915 + 1.31 × 0.397) × $33.4009 = $420.19

Open 27500 in the RVU calculator

Payment rules and modifiers for 27500

27500 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 27500

Femur fracture care, shaft, no manipulation

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)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
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 · 27500

Femur fracture care, shaft, no manipulation

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

27500 without 50 · national office

$574.50

Femur fracture care, shaft, no manipulation

27500-50 · Bilateral: 150%

$861.75

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

Codes related to 27500

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

Codes related to 27500
CodeHow it relatesOffice range, Iowa
Same family
27502Femur fracture care, shaft fracture, manipulationClosed treatment of a femoral shaft fracture when manipulation is performed.No office rate
Used instead
27506Femur fracture repair, intramedullary implantOperative treatment of a femoral shaft fracture using an intramedullary implant.No office rate
27507Femur fracture repair, plate-and-screw fixationOperative treatment of a femoral shaft fracture using plate-and-screw fixation.No office rate
27508Femur fracture care, distal condyle, no manipulationClosed treatment without manipulation applies to the distal femur rather than the shaft.$527.11

How 27500 has changed in Iowa

27500 · Office / nonfacility

$520.43

Effective 2026-10-01

The base rate is $43.60 higher than on 2025-10-01, moving from $476.83 to $520.43 (9.1%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    $476.83changed to$520.43

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 6.30 changed to 6.14
    • Practice expense RVU 8.61 changed to 9.75
    • Malpractice RVU 1.27 changed to 1.31
    • Practice expense GPCI 0.913 changed to 0.915
    • Malpractice GPCI 0.457 changed to 0.397

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $487.06changed to$476.83

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 8.48 changed to 8.61
    • Malpractice RVU 1.29 changed to 1.27

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $479.11changed to$487.06

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $490.43changed to$479.11

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 8.37 changed to 8.48
    • Malpractice RVU 1.26 changed to 1.29
    • Practice expense GPCI 0.910 changed to 0.913
    • Malpractice GPCI 0.441 changed to 0.457

  5. January 1, 2023

    RVU23A

    $489.06changed to$490.43

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 8.04 changed to 8.37
    • Malpractice RVU 1.27 changed to 1.26
    • Practice expense GPCI 0.907 changed to 0.910
    • Malpractice GPCI 0.425 changed to 0.441

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $490.28changed to$489.06

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 7.96 changed to 8.04
    • Malpractice RVU 1.25 changed to 1.27

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $490.53changed to$490.28

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 7.46 changed to 7.96
    • Malpractice RVU 1.24 changed to 1.25
    • Malpractice GPCI 0.424 changed to 0.425

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $487.88changed to$490.53

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 7.42 changed to 7.46
    • Malpractice RVU 1.20 changed to 1.24
    • Malpractice GPCI 0.423 changed to 0.424

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $487.19changed to$487.88

    • Conversion factor 35.9996 changed to 36.0391
    • Malpractice RVU 1.19 changed to 1.20

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $483.27changed to$487.19

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 7.33 changed to 7.42
    • Malpractice RVU 1.21 changed to 1.19
    • Practice expense GPCI 0.902 changed to 0.907
    • Malpractice GPCI 0.458 changed to 0.423

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $482.11changed to$483.27

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 7.32 changed to 7.33
    • Malpractice RVU 1.23 changed to 1.21
    • Practice expense GPCI 0.896 changed to 0.902
    • Malpractice GPCI 0.493 changed to 0.458

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $485.67changed to$482.11

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 7.36 changed to 7.32
    • Malpractice RVU 1.26 changed to 1.23

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $483.25changed to$485.67

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $476.30changed to$483.25

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 7.22 changed to 7.36
    • Malpractice RVU 1.17 changed to 1.26
    • Practice expense GPCI 0.892 changed to 0.896
    • Malpractice GPCI 0.475 changed to 0.493

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $471.68changed to$476.30

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 7.90 changed to 7.22
    • Malpractice RVU 1.22 changed to 1.17
    • Practice expense GPCI 0.887 changed to 0.892
    • Malpractice GPCI 0.456 changed to 0.475

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $471.68

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$520.43$420.19RVU26D
2026-07-01$520.43$420.19RVU26C
2026-04-01$520.43$420.19RVU26B
2026-01-01$520.43$420.19RVU26A
2025-10-01$476.83$437.26RVU25D
2025-07-01$476.83$437.26RVU25C
2025-04-01$476.83$437.26RVU25B
2025-01-01$476.83$437.26RVU25A
2024-10-01$487.06$446.63RVU24D
2024-07-01$487.06$446.63RVU24C
2024-04-01$487.06$446.63RVU24B
2024-03-09$487.06$446.63RVU24AR
2024-01-01$479.11$439.34RVU24A
2023-10-01$490.43$450.03RVU23D
2023-07-01$490.43$450.03RVU23C
2023-04-01$490.43$450.03RVU23B
2023-01-01$490.43$450.03RVU23A
2022-10-01$489.06$449.51RVU22D
2022-07-01$489.06$449.51RVU22C
2022-04-01$489.06$449.51RVU22B
2022-01-01$489.06$449.51RVU22A
2021-10-01$490.28$450.41RVU21D
2021-07-01$490.28$450.41RVU21C
2021-04-01$490.28$450.41RVU21B
2021-01-01$490.28$450.41RVU21A
2020-10-01$490.53$452.89RVU20D
2020-07-01$490.53$452.89RVU20C
2020-04-01$490.53$452.89RVU20B
2020-01-01$490.53$452.89RVU20A
2019-10-01$487.88$450.29RVU19D
2019-07-01$487.88$450.29RVU19C
2019-04-01$487.88$450.29RVU19B
2019-01-01$487.88$450.29RVU19A
2018-10-01$487.19$450.30RVU18D
2018-07-01$487.19$450.30RVU18C
2018-04-01$487.19$450.30RVU18B
2018-01-01$487.19$450.30RVU18AR1
2017-10-01$483.27$447.99RVU17D
2017-07-01$483.27$447.99RVU17C
2017-04-01$483.27$447.99RVU17B
2017-01-01$483.27$447.99RVU17A
2016-10-01$482.11$447.14RVU16D
2016-07-01$482.11$447.14RVU16C
2016-04-01$482.11$447.14RVU16B
2016-01-01$482.11$447.14RVU16A
2015-10-01$485.67$450.25RVU15D
2015-07-01$485.67$450.25RVU15C
2015-04-01$483.25$448.01RVU15B
2015-01-01$483.25$448.01RVU15A
2014-10-01$476.30$442.11RVU14D
2014-07-01$476.30$442.11RVU14C
2014-04-01$476.30$442.11RVU14B
2014-01-01$476.30$442.11RVU14A
2013-10-01$471.68$435.77RVU13D
2013-07-01$471.68$435.77RVU13C
2013-04-01$471.68$435.77RVU13B
2013-01-01$471.68$435.77RVU13AR

Price 27500 for an earlier date of service

Where the Iowa rate applies

Iowa is a Medicare payment area, not a city. Our Census mapping connects it to 1026 cities and communities in Iowa. Some span more than one payment area; confirm with the service ZIP.

  • Ackley
  • Ackworth
  • Adair
  • Adel
  • Afton
  • Agency
  • Ainsworth
  • Akron

Browse all communities in Iowa

27500 billing questions

When should 27500 be chosen instead of 27502?

Use 27500 when the femoral shaft fracture is treated without manipulating its alignment. When the provider manipulates the fracture, consider 27502.

What documentation supports reporting 27500?

Document that the fracture is in the femoral shaft, that treatment was closed, and that no manipulation or reduction was performed.

Does the 90-day global period include follow-up care?

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

How is bilateral treatment handled?

For bilateral treatment reported with modifier 50, CMS pays at 150%.

Can an assistant or co-surgeon be reported for this procedure?

CMS does not pay an assistant at surgery for this code, and co-surgeons and team surgery are not permitted.

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 27500PPRRVU2026_Oct_nonQPP.csv, line 2,922 (RVU26D)
Geographic factors for IowaGPCI2026.csv, line 53 (RVU26D)

Open CMS sourceHow we calculate rates

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