Billing code 27256: Hip reductionMedicare rate & RVUs

Medicare pays $403.82 for 27256 nationally in the office and $261.86 in a hospital or facility. Local office rates run $354.45–$504.29.

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

What 27256 covers

billing code 27256 represents closed manipulation under anesthesia to reposition a hip affected by developmental dislocation, often in a young child with developmental dysplasia of the hip. A pediatric orthopedic surgeon typically performs the reduction in an operating room or another setting where anesthesia is provided. The procedure uses a closed approach rather than surgically exposing the joint. The related code 27257 distinguishes treatment that includes application of a spica cast.

Select 27256 when the documented diagnosis and treatment are for developmental hip dislocation and the surgeon performs closed manipulation under anesthesia. The operative report should identify the affected hip, the closed reduction, and the use of anesthesia; distinguish the service from traumatic dislocation treatment and open reduction. CMS includes related postoperative visits for 10 days in the global period. For bilateral treatment, modifier 50 is paid at 150%. When multiple procedures occur in one session, the highest-valued procedure is paid in full and others at 50%. An assistant is paid only with documented medical necessity; 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 27256 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

27256 rates by state

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

How the 27256 rate is calculated

Each of 27256’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 27256

27256 has a 10-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

27256 compared with similar codes

How to choose

27257Hip reduction

Both address closed treatment of developmental hip dislocation under anesthesia. The distinguishing service for 27257 is application of a spica cast.

27258Hip dislocation

Use 27256 for closed manipulation under anesthesia. Use 27258 when the surgeon treats the developmental dislocation through an open approach.

27252Hip reduction

27252 concerns traumatic hip dislocation treated closed with anesthesia; 27256 is for developmental hip dislocation.

27266Hip reduction

27266 describes closed treatment under anesthesia of a dislocated hip prosthesis, not developmental hip dislocation.

Codes related to 27256

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

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