Billing code 27516: Growth plate fractureMedicare rate & RVUs

Medicare pays $573.16 for 27516 nationally in the office and $477.63 in a hospital or facility. Local office rates run $504.57–$730.65.

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

What 27516 covers

This code describes closed treatment of a separation at the growth plate near the knee end of the femur, without manipulating the fracture. It is used most often for a child or adolescent with a distal femoral physeal injury managed without open exposure or reduction. An orthopedic surgeon commonly provides this care, including in a hospital or other facility setting; the treatment may include immobilization and follow-up of the healing injury.

Select this code when the documented injury is a distal femoral epiphyseal separation and the provider treats it without manipulation. The record should identify the physis involved, the fracture diagnosis, and the treatment provided. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. 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. For bilateral treatment reported with modifier 50, CMS pays at 150%. Assistant-at-surgery payment is restricted; 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 27516 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

27516 rates by state

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

How the 27516 rate is calculated

Each of 27516’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 27516

27516 has a 90-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

27516 compared with similar codes

How to choose

27517Growth plate fracture

Both codes treat a distal femoral physeal separation closed. Choose 27516 when treatment is without manipulation; 27517 represents treatment with manipulation.

27519Physeal fracture repair

This code is for closed treatment without manipulation. 27519 is used when the distal femoral physeal separation is treated operatively through an open approach.

27510Femur fracture care

27510 addresses closed treatment of a distal femoral fracture without manipulation that is not identified as an epiphyseal separation. Use 27516 for the physeal injury.

Codes related to 27516

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