CPT code 27509: Femur fracture fixation, percutaneous shaft fixation2026 Medicare rate & RVUs in Missouri
Percutaneous fixation of a femoral shaft fracture is reported when the surgeon stabilizes the fracture through small incisions without open exposure.
CMS doesn’t publish an office rate for 27509 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 27509 covers
An orthopedic surgeon uses percutaneous fixation to stabilize a femoral shaft fracture by placing fixation devices through small incisions, rather than exposing the fracture through an open approach. The service may involve manipulation to align the fracture before fixation. It is typically performed in a hospital or ambulatory surgical setting; the operative report should identify the shaft fracture, the percutaneous approach, and the fixation performed.
Choose this code when the operative method is percutaneous skeletal fixation, not closed fracture care alone or open fixation. The documentation should support the fracture location and describe the approach and stabilization. CMS assigns a 90-day global period, including 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 others at 50%. Bilateral reporting with modifier 50 is paid at 150%. An assistant is paid only when medical necessity is documented; 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 27509 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 | $631.13 |
| Metropolitan St. Louis, MO | Unavailable | $636.83 |
| Rest of Missouri | Unavailable | $605.40 |
How the 27509 rate is calculated
Each of 27509’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 · 27509
RVUs × geographic indexes × conversion factor
Work7.94
7.94 RVUs× 1.000 GPCI
Practice expense9.94
9.94 RVUs× 1.000 GPCI
Malpractice1.66
1.66 RVUs× 1.000 GPCI
Adjusted RVUs
19.5400
Conversion factor
$33.4009
Medicare rate
$652.65
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 27509
27509 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 27509
Femur fracture fixation, percutaneous shaft fixation
| 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) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| 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 · 27509
Femur fracture fixation, percutaneous shaft fixation
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
27509 without 50 · national facility
$652.65
Femur fracture fixation, percutaneous shaft fixation
27509-50 · Bilateral: 150%
$978.98
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).
27509 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 27506Femur fracture repairIntramedullary implant
- Use 27509 when skeletal fixation is performed percutaneously. Use 27506 for open treatment with an intramedullary implant.
- 27507Femur fracture repairPlate-and-screw fixation
- Use 27507 for open femoral shaft fixation with a plate-and-screw construct; 27509 represents percutaneous skeletal fixation.
- 27502Femur fracture careShaft fracture, manipulation
- 27502 represents closed treatment with manipulation, with or without traction. Choose 27509 when the surgeon performs percutaneous skeletal fixation.
27509 billing questions
How is this code different from open femoral shaft fixation?
Use 27509 for percutaneous skeletal fixation. Open treatment with an intramedullary implant or a plate-and-screw construct is described by 27506 or 27507, respectively.
Can it be reported for closed fracture treatment without fixation?
No. This code describes percutaneous stabilization; closed treatment without skeletal fixation is represented by a different femoral shaft fracture code.
What documentation supports choosing this code?
The operative report should identify the femoral shaft fracture and document the percutaneous approach and skeletal fixation performed. Include any manipulation used to align the fracture.
How is bilateral treatment reported?
CMS identifies this as a bilateral procedure; reporting modifier 50 is paid at 150%.
Can an assistant surgeon or co-surgeon be reported?
Assistant-at-surgery payment requires documentation of medical necessity. CMS does not permit co-surgeons or team surgery for this code.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
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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