No office rate
Use 27245 when the fracture is stabilized with an intramedullary implant. Use 27244 when the documented fixation uses a plate-and-screw type implant.
On this page
CMS RVU26D · Effective 2026-10-01
27245 Femur fracture fixation Medicare reimbursement rates
Reports operative fixation of an intertrochanteric, peritrochanteric, or subtrochanteric femoral fracture using an intramedullary implant. Compare 27245 office and facility rates across CMS payment localities.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 27245?
The service location and office or facility setting determine which base rate applies. These are the supported base rates for the 109 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Where 27245 pays more and less
Orthopedic surgery
About 27245: Proximal femur fracture fixation with intramedullary nail
Reports operative fixation of an intertrochanteric, peritrochanteric, or subtrochanteric femoral fracture using an intramedullary implant.
An orthopedic surgeon uses an intramedullary implant to stabilize a fracture in the upper femur, such as an intertrochanteric or subtrochanteric fracture. The implant is placed through the proximal femur and extends into the bone’s medullary canal; interlocking screws or cerclage may also be used. This procedure is commonly performed in a hospital operating room for patients whose fracture pattern and treatment plan call for operative stabilization.
Select this code when the operative report supports the specified fracture region and intramedullary fixation method; the implant and operative details distinguish it from plate-and-screw fixation or closed treatment. The service has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment and co-surgeons are permitted; team surgery is not permitted.
CMS billing rules for 27245
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral procedure with modifier 50 is paid at 150%.
- Assistant at surgery
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU17.73 · 53%
- Practice expense (office) RVU12.04 · 36%
- Malpractice RVU3.71 · 11%
94.7K
Medicare services in 2024 · #578 by national volume
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.
27245 compared with similar codes
Office rate ranges across all CMS payment localities, from the same CMS release.
No office rate
This code reports operative intramedullary fixation. Code 27240 describes closed treatment of an intertrochanteric, peritrochanteric, or subtrochanteric fracture.
No office rate
Code 27236 is for open treatment of a femoral neck fracture. Code 27245 applies to specified intertrochanteric, peritrochanteric, or subtrochanteric fractures treated with an intramedullary implant.
See how rates vary across the country
27245 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.
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.
View all state and territory rates as a table
| State / territory | Rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
Compare 27245 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | Office Unavailable | Facility $1014.21 |
| Alaska* | Office Unavailable | Facility $1384.86 |
| Arizona | Office Unavailable | Facility $1087.95 |
| Arkansas | Office Unavailable | Facility $1001.46 |
| Atlanta | Office Unavailable | Facility $1151.38 |
| Austin | Office Unavailable | Facility $1128.64 |
| Bakersfield | Office Unavailable | Facility $1119.67 |
| Baltimore/Surr. Cntys | Office Unavailable | Facility $1186.46 |
| Beaumont | Office Unavailable | Facility $1073.27 |
| Brazoria | Office Unavailable | Facility $1092.12 |
| Chicago | Office Unavailable | Facility $1284.89 |
| Chico | Office Unavailable | Facility $1109.44 |
| Colorado | Office Unavailable | Facility $1123.97 |
| Connecticut | Office Unavailable | Facility $1187.09 |
| Dallas | Office Unavailable | Facility $1104.39 |
| Dc + Md/Va Suburbs | Office Unavailable | Facility $1235.83 |
| Delaware | Office Unavailable | Facility $1103.88 |
| Detroit | Office Unavailable | Facility $1189.19 |
| East St. Louis | Office Unavailable | Facility $1211.74 |
| El Centro | Office Unavailable | Facility $1110.06 |
| Fort Lauderdale | Office Unavailable | Facility $1223.62 |
| Fort Worth | Office Unavailable | Facility $1101.98 |
| Fresno | Office Unavailable | Facility $1109.44 |
| Galveston | Office Unavailable | Facility $1098.87 |
| Hanford-Corcoran | Office Unavailable | Facility $1109.44 |
| Hawaii, Guam | Office Unavailable | Facility $1121.19 |
| Houston | Office Unavailable | Facility $1166.78 |
| Idaho | Office Unavailable | Facility $1020.79 |
| Indiana | Office Unavailable | Facility $1025.21 |
| Iowa | Office Unavailable | Facility $1009.36 |
| Kansas | Office Unavailable | Facility $1018.19 |
| Kentucky | Office Unavailable | Facility $1063.09 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Office Unavailable | Facility $1174.50 |
| Madera | Office Unavailable | Facility $1109.44 |
| Manhattan | Office Unavailable | Facility $1293.93 |
| Merced | Office Unavailable | Facility $1109.44 |
| Metropolitan Boston | Office Unavailable | Facility $1206.93 |
| Metropolitan Kansas City | Office Unavailable | Facility $1090.88 |
| Metropolitan Philadelphia | Office Unavailable | Facility $1169.33 |
| Metropolitan St. Louis | Office Unavailable | Facility $1099.21 |
| Miami | Office Unavailable | Facility $1324.22 |
| Minnesota | Office Unavailable | Facility $1042.69 |
| Mississippi | Office Unavailable | Facility $1030.02 |
| Modesto | Office Unavailable | Facility $1109.44 |
| Montana** | Office Unavailable | Facility $1118.01 |
| Napa | Office Unavailable | Facility $1222.49 |
| Nebraska | Office Unavailable | Facility $1010.22 |
| Nevada** | Office Unavailable | Facility $1097.97 |
| New Hampshire | Office Unavailable | Facility $1119.26 |
| New Mexico | Office Unavailable | Facility $1109.79 |
| New Orleans | Office Unavailable | Facility $1111.39 |
| North Carolina | Office Unavailable | Facility $1046.58 |
| North Dakota** | Office Unavailable | Facility $1044.66 |
| Northern Nj | Office Unavailable | Facility $1228.34 |
| Nyc Suburbs/Long Island | Office Unavailable | Facility $1338.37 |
| Ohio | Office Unavailable | Facility $1084.27 |
| Oklahoma | Office Unavailable | Facility $1047.60 |
| Oxnard-Thousand Oaks-Ventura | Office Unavailable | Facility $1161.32 |
| Portland | Office Unavailable | Facility $1140.65 |
| Poughkpsie/N Nyc Suburbs | Office Unavailable | Facility $1209.14 |
| Puerto Rico | Office Unavailable | Facility $1120.83 |
| Queens | Office Unavailable | Facility $1284.12 |
| Redding | Office Unavailable | Facility $1109.44 |
| Rest Of California | Office Unavailable | Facility $1109.44 |
| Rest Of Florida | Office Unavailable | Facility $1162.90 |
| Rest Of Georgia | Office Unavailable | Facility $1098.62 |
| Rest Of Illinois | Office Unavailable | Facility $1153.04 |
| Rest Of Louisiana | Office Unavailable | Facility $1066.81 |
| Rest Of Maine | Office Unavailable | Facility $1039.25 |
| Rest Of Maryland | Office Unavailable | Facility $1118.85 |
| Rest Of Massachusetts | Office Unavailable | Facility $1123.90 |
| Rest Of Michigan | Office Unavailable | Facility $1099.26 |
| Rest Of Missouri | Office Unavailable | Facility $1059.54 |
| Rest Of New Jersey | Office Unavailable | Facility $1190.97 |
| Rest Of New York | Office Unavailable | Facility $1061.35 |
| Rest Of Oregon | Office Unavailable | Facility $1079.85 |
| Rest Of Pennsylvania | Office Unavailable | Facility $1078.47 |
| Rest Of Texas | Office Unavailable | Facility $1085.73 |
| Rest Of Washington | Office Unavailable | Facility $1117.66 |
| Rhode Island | Office Unavailable | Facility $1129.40 |
| Riverside-San Bernardino-Ontario | Office Unavailable | Facility $1149.31 |
| Sacramento-Roseville-Folsom | Office Unavailable | Facility $1147.63 |
| Salinas | Office Unavailable | Facility $1143.06 |
| San Diego-Chula Vista-Carlsbad | Office Unavailable | Facility $1158.09 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Office Unavailable | Facility $1272.36 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Office Unavailable | Facility $1268.15 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Office Unavailable | Facility $1303.66 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Office Unavailable | Facility $1286.43 |
| San Luis Obispo-Paso Robles | Office Unavailable | Facility $1126.73 |
| Santa Cruz-Watsonville | Office Unavailable | Facility $1159.66 |
| Santa Maria-Santa Barbara | Office Unavailable | Facility $1144.10 |
| Santa Rosa-Petaluma | Office Unavailable | Facility $1170.22 |
| Seattle (King Cnty) | Office Unavailable | Facility $1216.48 |
| South Carolina | Office Unavailable | Facility $1069.11 |
| South Dakota** | Office Unavailable | Facility $1035.98 |
| Southern Maine | Office Unavailable | Facility $1068.92 |
| Stockton | Office Unavailable | Facility $1109.44 |
| Suburban Chicago | Office Unavailable | Facility $1228.93 |
| Tennessee | Office Unavailable | Facility $1024.29 |
| Utah | Office Unavailable | Facility $1081.49 |
| Vallejo | Office Unavailable | Facility $1216.41 |
| Vermont | Office Unavailable | Facility $1053.03 |
| Virgin Islands | Office Unavailable | Facility $1120.83 |
| Virginia | Office Unavailable | Facility $1074.99 |
| Visalia | Office Unavailable | Facility $1109.44 |
| West Virginia | Office Unavailable | Facility $1118.99 |
| Wisconsin | Office Unavailable | Facility $1015.62 |
| Wyoming** | Office Unavailable | Facility $1086.04 |
| Yuba City | Office Unavailable | Facility $1109.44 |
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27245 billing questions
How does this differ from code 27244?
Both address intertrochanteric, peritrochanteric, or subtrochanteric fractures. Report 27245 for intramedullary implant fixation and 27244 when the operative method uses a plate-and-screw type implant.
Can this code be used for a femoral neck fracture?
No. This code is for specified proximal femoral fracture patterns outside the femoral neck; select a femoral-neck treatment code when that is the documented fracture site.
Are related postoperative visits included?
Yes. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How is bilateral surgery reported?
For bilateral procedures, report modifier 50; CMS pays the procedure at 150%.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be made, and co-surgeons are permitted. Team surgery is not permitted for this code.
What happens when another procedure is performed in the same session?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and the other procedure or procedures are paid at 50%.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
2,79927238,,Treat thigh fracture,A,,5.61,6.88,NA,6.88,,1.21,13.70,13.70,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,80027240,,Treat thigh fracture,A,,13.46,10.50,NA,10.50,,2.93,26.89,26.89,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,80127244,,Treat thigh fracture,A,,17.73,12.09,NA,12.09,,3.75,33.57,33.57,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,80227245,,Treat thigh fracture,A,,17.73,12.04,NA,12.04,,3.71,33.48,33.48,0,090,0.10,0.69,0.21,2,1,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,80327246,,Treat thigh fracture,A,,4.71,7.09,,5.58,,1.01,12.81,11.30,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,80427248,,Treat thigh fracture,A,,10.51,7.81,NA,7.81,,2.21,20.53,20.53,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,80527250,,Treat hip dislocation,A,,3.72,0.61,NA,0.61,,0.90,5.23,5.23,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00