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CPT code 27506: Femur fracture repair, intramedullary implant2026 Medicare rate & RVUs

Reports operative stabilization of a femoral shaft fracture using an intramedullary implant, with or without cerclage or locking screws.

CMS RVU26DEffective Oct 1, 2026109 payment localities11.4K Medicare services in 2024

Medicare pays $1,223.14 for 27506 nationally in a facility.

Medicare rate · 27506

Femur fracture repair, intramedullary implant

Office or facility?

Work RVUs
19.16
Total RVUs
36.62
Global days
090

National rate · 2026

$1,223.14

Facility setting, before claim adjustments.

See every locality for 27506 →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 27506 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 27506 covers

An orthopedic surgeon uses an intramedullary implant, commonly a nail or rod placed within the femur, to stabilize a shaft fracture. The operation may include cerclage or locking screws. This code describes open treatment of the femoral shaft, not fracture care limited to the knee or growth plate. Medicare claims predominantly involve facility services for this operation.

Select the code when the operative report supports treatment of a femoral shaft fracture with an intramedullary implant; document the fracture site and fixation method, including any cerclage or locking screws. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and the others at 50%. For bilateral procedures reported with modifier 50, CMS pays at 150%. An assistant at surgery may be paid; co-surgeon payment requires 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 27506 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

27506 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$1,108.65
AlaskaUnavailable$1,511.84
ArizonaUnavailable$1,189.85
ArkansasUnavailable$1,094.61
Atlanta, GAUnavailable$1,259.29
Austin, TXUnavailable$1,235.09
Bakersfield, CAUnavailable$1,225.73
Baltimore area, MDUnavailable$1,298.03
Beaumont, TXUnavailable$1,173.21
Brazoria, TXUnavailable$1,194.61

27506 rates by state

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

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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
27506 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 27506 rate is calculated

Each of 27506’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 · 27506

RVUs × geographic indexes × conversion factor

Office or facility?

Work19.16

19.16 RVUs× 1.000 GPCI

Practice expense13.43

13.43 RVUs× 1.000 GPCI

Malpractice4.03

4.03 RVUs× 1.000 GPCI

Adjusted RVUs

36.6200

Conversion factor

$33.4009

Medicare rate

$1,223.14

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

Payment rules and modifiers for 27506

27506 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 27506

Femur fracture repair, 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)1Permitted with supporting documentation.
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 · 27506

Femur fracture repair, 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

27506 without 50 · national facility

$1,223.14

Femur fracture repair, intramedullary implant

27506-50 · Bilateral: 150%

$1,834.71

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

27506 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 27506

    Femur fracture repair, intramedullary implant19.16 wRVU

    Not priced

  • 27507

    Femur fracture repair, plate-and-screw fixation14.12 wRVU

    Not priced

  • 27502

    Femur fracture care, shaft fracture, manipulation11.08 wRVU

    Not priced

  • 27500

    Femur fracture care, shaft, no manipulation6.14 wRVU

    $574.50

How to choose

27507Femur fracture repairPlate-and-screw fixation
Choose 27506 for intramedullary implant fixation of the femoral shaft; choose 27507 when the shaft is treated with plate-and-screw fixation.
27502Femur fracture careShaft fracture, manipulation
27502 describes closed treatment of a femoral shaft fracture with manipulation. This code describes operative stabilization using an intramedullary implant.
27500Femur fracture careShaft, no manipulation
27500 is closed treatment without manipulation. Use this code when the femoral shaft fracture is operatively stabilized with an intramedullary implant.

Codes related to 27506

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

Codes related to 27506
CodeHow it relatesNational office range
Used instead
27507Femur fracture repair, plate-and-screw fixationTreats a femoral shaft fracture using plate-and-screw fixation rather than an intramedullary implant.No office rate
27502Femur fracture care, shaft fracture, manipulationClosed treatment with manipulation rather than operative fixation with an intramedullary implant.No office rate
27500Femur fracture care, shaft, no manipulationClosed treatment without manipulation, rather than intramedullary fixation.$507.36–$720.69

27506 billing questions

When should this code be chosen over 27507?

Use 27506 when the femoral shaft is stabilized with an intramedullary implant. Code 27507 describes fixation with a plate and screws.

How does this differ from closed fracture treatment?

This code reports operative fixation with an intramedullary implant. Codes 27500 and 27502 describe closed treatment, without and with manipulation, respectively.

Are cerclage or locking screws reported separately?

They are included as possible components of this fracture treatment when used with the intramedullary implant; they do not change the code selection.

What postoperative care is included?

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

Can an assistant or co-surgeon be paid?

An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation; team surgery is not permitted.

How is bilateral treatment handled?

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

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 27506PPRRVU2026_Oct_nonQPP.csv, line 2,926 (RVU26D)

Open CMS sourceHow we calculate rates

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