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Billing code 27268: Femoral head fractureMedicare rate & RVUs

Reports closed treatment of a femoral head fracture when the physician manipulates the fracture, with or without skeletal traction.

CMS RVU26DEffective Oct 1, 2026109 payment localities21 Medicare services in 2024

Medicare pays $516.38 for 27268 nationally in a facility.

Medicare rate · 27268

Femoral head fracture

Swap in your local Medicare rate.

Work RVUs
6.94
Total RVUs
15.46
Global days
090

National rate · 2026

$516.38

Facility setting, before claim adjustments.

See every locality for 27268 → · 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
  1. Medicare rate
  2. What 27268 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 27268 covers

An orthopedic surgeon typically performs this closed treatment in a hospital or surgical facility, often under anesthesia. The physician manipulates the femoral head fracture without surgically exposing it; skeletal traction may also be used. Femoral head fractures can occur with hip dislocation, but this service addresses the fracture rather than the dislocation itself.

Select this code when documentation supports a femoral head fracture and manipulation as part of its treatment. The record should identify the fracture site and describe the reduction or other manipulation performed; imaging and documentation of traction, if used, can support the service. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care. For multiple procedures in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple procedure reduction. Modifier 50 indicates bilateral treatment, paid at 150%. An assistant at surgery may be paid; co-surgeons require supporting documentation, and team surgery is 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 27268 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

27268 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$465.63
Alaska*Unavailable$625.54
ArizonaUnavailable$502.01
ArkansasUnavailable$459.36
AtlantaUnavailable$530.71
AustinUnavailable$524.90
BakersfieldUnavailable$524.19
Baltimore/Surr. CntysUnavailable$548.91
BeaumontUnavailable$491.70
BrazoriaUnavailable$505.31

27268 rates by state

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

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Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

View every state and territory as a table
27268 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 27268 rate is calculated

Each of 27268’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 · 27268

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 6.94Practice expense 7.05Malpractice 1.47

15.4600 adjusted RVUs×$33.4009 conversion factor=$516.38

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 27268

27268 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 27268

Femoral head fracture

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
Assistant at surgery (80/81/82/AS)2Paid.
Co-surgeons (62)1Permitted with supporting documentation.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.69/0.21Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 27268

Femoral head fracture

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.

  • 24 Unrelated E/M visit by the same physician
  • 79 Unrelated procedure (starts its own global period)
  • 58 Staged, more extensive, or therapy procedure that was planned
  • 78 Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 50 · payment effect

With and without the modifier

27268 without 50 · national facility

$516.38

Femoral head fracture

27268-50 · Bilateral: 150%

$774.57

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).

When to use modifier 50

27268 compared with similar codes

Compare codes

27268 vs 27267 vs 27269 vs 27252: national Medicare rates

Swap in your local Medicare rate.

  • 27268
    Femoral head fracture · 6.94 wRVU
    —
  • 27267
    Fracture treatment · 5.36 wRVU
    —
  • 27269
    Femoral fracture repair · 18.42 wRVU
    —
  • 27252
    Hip reduction · 10.75 wRVU
    —

How to choose

27267Fracture treatment
Both describe closed treatment of a femoral head fracture. Choose 27268 when manipulation is performed; choose 27267 when it is not.
27269Femoral fracture repair
This code describes open treatment of a femoral head fracture. Use 27268 for closed treatment with manipulation.
27252Hip reduction
This code addresses closed treatment of a hip dislocation requiring anesthesia, not manipulation of a femoral head fracture. Identify which injury the documented service treats.

Codes related to 27268

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

Codes related to 27268
CodeHow it relatesNational office range
Same family
27267Fracture treatmentClosed treatment of a femoral head fracture without manipulation.No office rate
27269Femoral fracture repairOpen treatment of a femoral head fracture.No office rate
Often billed with
27252Hip reductionMay relate to treatment of a concomitant hip dislocation during the same encounter.No office rate
27253Hip dislocationOpen treatment of a concomitant hip dislocation may occur in the same encounter.No office rate

27268 billing questions

How does this differ from 27267?

Use 27268 when the physician manipulates the femoral head fracture. Code 27267 describes closed treatment without manipulation.

When is 27269 more appropriate?

Use 27269 for open treatment of a femoral head fracture. Code 27268 describes closed treatment with manipulation, without surgically exposing the fracture.

Does this code cover reduction of an associated hip dislocation?

The code describes treatment of the femoral head fracture, not the hip dislocation. If a dislocation is also treated, document that service separately and determine the appropriate reporting under applicable coding rules.

What documentation supports reporting 27268?

Document the femoral head fracture and the manipulation performed to treat it. Note skeletal traction when used, along with relevant imaging and treatment details.

How does the 90-day global period affect postoperative visits?

The day-before preoperative visit and 90 days of related postoperative care are included in the global period.

Can modifier 50 or an assistant-at-surgery claim apply?

CMS treats this as a bilateral procedure when modifier 50 is reported, with payment at 150%. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation.

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
RVUs for 27268PPRRVU2026_Oct_nonQPP.csv, line 2,816 (RVU26D)

Open CMS sourceHow we calculate rates

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