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Billing code 27514: Distal femur fractureMedicare rate & RVUs

Reports operative treatment of a distal femoral supracondylar or transcondylar fracture extending between the condyles, with fixation included when performed.

CMS RVU26DEffective Oct 1, 2026109 payment localities2.2K Medicare services in 2024

Medicare pays $875.10 for 27514 nationally in a facility.

Medicare rate · 27514

Distal femur fracture

Swap in your local Medicare rate.

Work RVUs
14.24
Total RVUs
26.20
Global days
090

National rate · 2026

$875.10

Facility setting, before claim adjustments.

See every locality for 27514 → · 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 27514 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 27514 covers

This code describes operative treatment of a distal femoral supracondylar or transcondylar fracture that extends into the intercondylar region. The surgeon exposes and reduces the fracture to restore the joint surface; internal fixation is included when used. An orthopedic surgeon typically performs the procedure in an operating room, often for a displaced fracture involving the distal femur and knee joint.

Select this code when the operative documentation establishes intercondylar extension and open treatment. The record should identify the fracture pattern and support the reduction and any fixation performed; fixation is not separately reported as a distinct service for the same fracture. CMS assigns 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 services 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 27514 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

27514 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$794.21
Alaska*Unavailable$1,087.38
ArizonaUnavailable$851.40
ArkansasUnavailable$784.31
AtlantaUnavailable$901.46
AustinUnavailable$881.99
BakersfieldUnavailable$873.69
Baltimore/Surr. CntysUnavailable$928.31
BeaumontUnavailable$841.05
BrazoriaUnavailable$854.17

27514 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
27514 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 27514 rate is calculated

Each of 27514’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 · 27514

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 14.24Practice expense 8.96Malpractice 3.00

26.2000 adjusted RVUs×$33.4009 conversion factor=$875.10

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

Payment rules and modifiers for 27514

27514 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 27514

Distal femur 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 · 27514

Distal femur 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

27514 without 50 · national facility

$875.10

Distal femur fracture

27514-50 · Bilateral: 150%

$1,312.65

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

27514 compared with similar codes

Compare codes

27514 vs 27513 vs 27510 vs 27511: national Medicare rates

Swap in your local Medicare rate.

  • 27514
    Distal femur fracture · 14.24 wRVU
    —
  • 27513
    Distal femur repair · 18.77 wRVU
    —
  • 27510
    Femur fracture care · 9.56 wRVU
    —
  • 27511
    Femur fracture · 14.73 wRVU
    —

How to choose

27513Distal femur repair
Both describe open treatment of distal femoral supracondylar or transcondylar fractures. Choose 27514 when the fracture extends into the intercondylar region; 27513 is for a pattern without that extension.
27510Femur fracture care
27510 is closed treatment without manipulation. Use 27514 for operative open treatment with intercondylar extension.
27511Femur fracture
27511 is closed treatment with manipulation, with or without skeletal traction. It does not describe open treatment of an intercondylar fracture.

Codes related to 27514

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

Codes related to 27514
CodeHow it relatesNational office range
Same family
27513Distal femur repairOpen treatment of the corresponding fracture pattern without intercondylar extension.No office rate
Used instead
27510Femur fracture careClosed treatment without manipulation for a supracondylar or transcondylar femur fracture.No office rate
27511Femur fractureClosed treatment with manipulation, with or without skeletal traction, for a supracondylar or transcondylar femur fracture.No office rate

27514 billing questions

How does 27514 differ from 27513?

Use 27514 when the distal femoral supracondylar or transcondylar fracture extends into the intercondylar region. Code 27513 describes the corresponding open treatment without intercondylar extension.

Does 27514 require internal fixation?

The code includes internal fixation when performed, but the distinguishing feature is open treatment of a fracture with intercondylar extension. Document the actual fracture pattern and treatment.

Can fixation be billed separately for the same fracture?

Internal fixation performed as part of the fracture treatment is included in 27514 and should not be reported separately as a distinct service for that fracture.

How does Medicare pay 27514 when other procedures are performed?

For procedures performed in the same session, Medicare pays the highest-valued procedure in full and the others at 50%. Bilateral reporting with modifier 50 is paid at 150%.

What should the record support for assistant or co-surgeon billing?

An assistant at surgery may be paid. Co-surgeons are paid only with supporting documentation; team surgery is not permitted.

What postoperative care is included?

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

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 27514PPRRVU2026_Oct_nonQPP.csv, line 2,933 (RVU26D)

Open CMS sourceHow we calculate rates

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