CPT code 27509: Femur fracture fixation, percutaneous shaft fixation2026 Medicare rate & RVUs in Puerto Rico

In Puerto Rico, Medicare pays $655.47 for 27509 in a facility. There’s no office rate.

Check a contract rate as a % of Medicare · 27509 nationwide

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

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.

How Puerto Rico compares for 27509

Across 109 of 109 payment localities, the facility rate for 27509 runs from $578.95 in Arkansas to $802.85 in San Benito County, CA. Puerto Rico pays $655.47. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

27509 rates by state

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

See 27509 in every payment locality

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.

Payment rules and modifiers for 27509

27509 has a 90-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 50

Codes related to 27509

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

How 27509 has changed in Puerto Rico

Price 27509 for an earlier date of service

Where the Puerto Rico rate applies

Puerto Rico is a Medicare payment area, not a city. Our Census mapping connects it to 292 cities and communities in Puerto Rico. Some span more than one payment area; confirm with the service ZIP.

• Aceitunas
• Adjuntas
• Aguada
• Aguadilla
• Aguas Buenas
• Aguas Claras
• Aguilita
• Aibonito

Browse all communities in Puerto Rico

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

Open CMS sourceHow we calculate rates