Billing code 27246: Femur fracture careMedicare rate & RVUs
Report this code for nonoperative treatment of a greater trochanter fracture when the physician manages the fracture without manipulating it.
Medicare pays $427.87 for 27246 nationally in the office and $377.43 in a hospital or facility. Local office rates run $378.11–$534.19.
Medicare rate · 27246
Femur fracture care
- Work RVUs
- 4.71
- Total RVUs
- 12.81
- Global days
- 090
National rate · 2026
$427.87
Office setting, before claim adjustments.
See every locality for 27246 →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.
On this page 10 sections
What 27246 covers
billing code 27246 covers nonoperative management of a fracture of the greater trochanter without manipulating the fracture. An orthopedist or other physician may provide this care in an orthopedic clinic or during a hospital encounter after imaging identifies the fracture. Treatment planning can include activity limits, protected weight bearing, and follow-up imaging as clinically indicated. This code represents fracture treatment, not an evaluation alone.
Document the greater trochanter fracture, the nonoperative treatment plan, and that manipulation was not performed. The code has a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Bilateral reporting with modifier 50 is paid at 150%. Medicare does not pay an assistant at surgery for this code; 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 27246 pays more and less
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
109 payment localities
$378.11 to $534.19
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $383.62 | $339.49 |
| Alaska* | $506.77 | $453.06 |
| Arizona | $415.67 | $366.79 |
| Arkansas | $378.11 | $334.79 |
| Atlanta | $438.91 | $387.66 |
| Austin | $438.07 | $384.71 |
| Bakersfield | $440.40 | $385.12 |
| Baltimore/Surr. Cntys | $455.67 | $401.55 |
| Beaumont | $404.16 | $358.26 |
| Brazoria | $419.57 | $369.59 |
| Chicago | $473.84 | $423.15 |
| Chico | $437.62 | $382.34 |
| Colorado | $437.52 | $383.86 |
| Connecticut | $456.33 | $402.01 |
| Dallas | $423.54 | $373.31 |
| Dc + Md/Va Suburbs | $482.33 | $422.91 |
| Delaware | $422.40 | $372.57 |
| Detroit | $442.72 | $394.05 |
| East St. Louis | $443.13 | $396.73 |
| El Centro | $437.79 | $382.51 |
| Fort Lauderdale | $458.20 | $407.11 |
| Fort Worth | $421.61 | $371.88 |
| Fresno | $437.62 | $382.34 |
| Galveston | $421.66 | $371.58 |
| Hanford-Corcoran | $437.62 | $382.34 |
| Hawaii, Guam | $446.11 | $388.76 |
| Houston | $440.15 | $390.07 |
| Idaho | $391.14 | $344.74 |
| Indiana | $393.24 | $346.48 |
| Iowa | $387.39 | $341.25 |
| Kansas | $388.40 | $342.81 |
| Kentucky | $398.71 | $353.87 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | $466.32 | $406.65 |
| Madera | $437.62 | $382.34 |
| Manhattan | $496.07 | $437.46 |
| Merced | $437.62 | $382.34 |
| Metropolitan Boston | $476.55 | $416.33 |
| Metropolitan Kansas City | $412.64 | $365.29 |
| Metropolitan Philadelphia | $446.92 | $394.41 |
| Metropolitan St. Louis | $416.57 | $368.55 |
| Miami | $489.16 | $436.65 |
| Minnesota | $410.98 | $359.09 |
| Mississippi | $386.14 | $342.72 |
| Modesto | $437.62 | $382.34 |
| Montana** | $427.80 | $377.36 |
| Napa | $496.49 | $430.01 |
| Nebraska | $388.65 | $342.10 |
| Nevada** | $422.47 | $371.98 |
| New Hampshire | $433.36 | $380.85 |
| New Mexico | $414.99 | $368.74 |
| New Orleans | $418.48 | $371.02 |
| North Carolina | $399.82 | $352.76 |
| North Dakota** | $407.83 | $357.39 |
| Northern Nj | $477.96 | $419.46 |
| Nyc Suburbs/Long Island | $511.60 | $451.63 |
| Ohio | $407.53 | $361.49 |
| Oklahoma | $395.00 | $349.96 |
| Oxnard-Thousand Oaks-Ventura | $462.65 | $403.04 |
| Portland | $448.03 | $392.00 |
| Poughkpsie/N Nyc Suburbs | $464.53 | $409.30 |
| Puerto Rico | $429.96 | $378.97 |
| Queens | $495.94 | $436.33 |
| Redding | $437.62 | $382.34 |
| Rest Of California | $437.62 | $382.34 |
| Rest Of Florida | $434.41 | $386.20 |
| Rest Of Georgia | $408.77 | $363.78 |
| Rest Of Illinois | $426.26 | $380.21 |
| Rest Of Louisiana | $399.22 | $354.58 |
| Rest Of Maine | $396.17 | $349.77 |
| Rest Of Maryland | $429.51 | $378.47 |
| Rest Of Massachusetts | $436.09 | $382.98 |
| Rest Of Michigan | $411.61 | $365.57 |
| Rest Of Missouri | $394.31 | $350.83 |
| Rest Of New Jersey | $459.22 | $404.14 |
| Rest Of New York | $406.01 | $358.09 |
| Rest Of Oregon | $416.90 | $366.67 |
| Rest Of Pennsylvania | $406.59 | $360.29 |
| Rest Of Texas | $412.52 | $364.65 |
| Rest Of Washington | $434.40 | $381.29 |
| Rhode Island | $435.03 | $382.93 |
| Riverside-San Bernardino-Ontario | $448.47 | $393.20 |
| Sacramento-Roseville-Folsom | $456.48 | $397.82 |
| Salinas | $454.74 | $396.29 |
| San Diego-Chula Vista-Carlsbad | $463.55 | $403.23 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | $521.65 | $450.54 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | $520.51 | $449.39 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | $534.19 | $461.46 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | $529.50 | $456.77 |
| San Luis Obispo-Paso Robles | $447.80 | $390.36 |
| Santa Cruz-Watsonville | $466.43 | $405.15 |
| Santa Maria-Santa Barbara | $455.93 | $397.12 |
| Santa Rosa-Petaluma | $470.93 | $408.99 |
| Seattle (King Cnty) | $483.31 | $421.43 |
| South Carolina | $404.81 | $358.21 |
| South Dakota** | $405.47 | $355.03 |
| Southern Maine | $413.29 | $363.30 |
| Stockton | $437.62 | $382.34 |
| Suburban Chicago | $461.40 | $409.61 |
| Tennessee | $390.70 | $344.85 |
| Utah | $410.22 | $362.81 |
| Vallejo | $494.83 | $428.36 |
| Vermont | $408.83 | $358.90 |
| Virgin Islands | $429.96 | $378.97 |
| Virginia | $413.92 | $364.34 |
| Visalia | $437.62 | $382.34 |
| West Virginia | $411.38 | $367.55 |
| Wisconsin | $394.57 | $346.26 |
| Wyoming** | $419.09 | $368.66 |
| Yuba City | $437.62 | $382.34 |
27246 rates by state
Office rate range in each state. Select a state to see its payment localities.
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.
$378.11
$506.77
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $506.77 | 1 |
| AL | $383.62 | 1 |
| AR | $378.11 | 1 |
| AZ | $415.67 | 1 |
| CA | $437.62–$534.19 | 29 |
| CO | $437.52 | 1 |
| CT | $456.33 | 1 |
| DC | $482.33 | 1 |
| DE | $422.40 | 1 |
| FL | $434.41–$489.16 | 3 |
| GA | $408.77–$438.91 | 2 |
| GU | $446.11 | 1 |
| HI | $446.11 | 1 |
| IA | $387.39 | 1 |
| ID | $391.14 | 1 |
| IL | $426.26–$473.84 | 4 |
| IN | $393.24 | 1 |
| KS | $388.40 | 1 |
| KY | $398.71 | 1 |
| LA | $399.22–$418.48 | 2 |
| MA | $436.09–$476.55 | 2 |
| MD | $429.51–$482.33 | 3 |
| ME | $396.17–$413.29 | 2 |
| MI | $411.61–$442.72 | 2 |
| MN | $410.98 | 1 |
| MO | $394.31–$416.57 | 3 |
| MS | $386.14 | 1 |
| MT | $427.80 | 1 |
| NC | $399.82 | 1 |
| ND | $407.83 | 1 |
| NE | $388.65 | 1 |
| NH | $433.36 | 1 |
| NJ | $459.22–$477.96 | 2 |
| NM | $414.99 | 1 |
| NV | $422.47 | 1 |
| NY | $406.01–$511.60 | 5 |
| OH | $407.53 | 1 |
| OK | $395.00 | 1 |
| OR | $416.90–$448.03 | 2 |
| PA | $406.59–$446.92 | 2 |
| PR | $429.96 | 1 |
| RI | $435.03 | 1 |
| SC | $404.81 | 1 |
| SD | $405.47 | 1 |
| TN | $390.70 | 1 |
| TX | $404.16–$440.15 | 8 |
| UT | $410.22 | 1 |
| VA | $413.92–$482.33 | 2 |
| VI | $429.96 | 1 |
| VT | $408.83 | 1 |
| WA | $434.40–$483.31 | 2 |
| WI | $394.57 | 1 |
| WV | $411.38 | 1 |
| WY | $419.09 | 1 |
How the 27246 rate is calculated
Each of 27246’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 · 27246
RVUs × geographic indexes × conversion factor
Work4.71
4.71 RVUs× 1.000 GPCI
Practice expense7.09
7.09 RVUs× 1.000 GPCI
Malpractice1.01
1.01 RVUs× 1.000 GPCI
Adjusted RVUs
12.8100
Conversion factor
$33.4009
Medicare rate
$427.87
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 27246
27246 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 27246
Femur fracture care
| 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) | 1 | Not paid (statutory restriction). |
| 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 · 27246
Femur fracture care
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
27246 without 50 · national office
$427.87
Femur fracture care
27246-50 · Bilateral: 150%
$641.81
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).
27246 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 27248Femoral fracture repair
- Use 27246 for nonoperative greater trochanter fracture treatment without manipulation; 27248 describes open treatment of that fracture.
- 27244Femur fracture repair
- This code concerns a greater trochanter fracture managed without manipulation. Code 27244 is for specified intertrochanteric, peritrochanteric, or subtrochanteric fractures treated with a plate or screw implant.
- 27238Femoral fracture care
- Use 27246 for a greater trochanter fracture. Code 27238 is for closed treatment of a femoral shaft fracture without manipulation.
27246 billing questions
How is 27246 different from 27248?
Use 27246 for nonoperative treatment of a greater trochanter fracture without manipulation. Code 27248 describes open treatment of a greater trochanter fracture.
What documentation supports reporting 27246?
Record the greater trochanter fracture, the treatment plan, and that the fracture was managed without manipulation. Include the clinical basis for treating the fracture rather than providing evaluation alone.
Is routine follow-up included?
Related postoperative care during the 90-day global period is included. The CMS global period also includes the day-before preoperative visit.
Can 27246 be reported bilaterally?
Yes. CMS pays bilateral reporting with modifier 50 at 150%.
Can an assistant surgeon or co-surgeon be billed?
Medicare does not pay an assistant at surgery for 27246. Co-surgeons and team surgery are not permitted.
When does the multiple-procedure reduction apply?
When other procedures are performed in the same session, the highest-valued procedure is paid in full and the others 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 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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