CPT code 27506: Femur fracture repair, intramedullary implant2026 Medicare rate & RVUs in Missouri
Reports operative stabilization of a femoral shaft fracture using an intramedullary implant, with or without cerclage or locking screws.
CMS doesn’t publish an office rate for 27506 in Missouri.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 sections
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 in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | Unavailable | $1,192.68 |
| Metropolitan St. Louis, MO | Unavailable | $1,201.88 |
| Rest of Missouri | Unavailable | $1,157.74 |
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
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
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.69/0.21 | Share 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.
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).
27506 compared with similar codes
Compare codes · National
4 codes, side by side
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.
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
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