No office rate
Use 27245 when the fracture is stabilized with an intramedullary implant. Use 27244 when the documented fixation uses a plate-and-screw type implant.
On this page
CMS RVU26D · Effective 2026-10-01
27245 in Merced
Office / nonfacility
Not available in this setting
Base rate per service
Facility setting
$1109.44
Base rate per service
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
Orthopedic surgery
About 27245: Proximal femur fracture fixation with intramedullary nail
Reports operative fixation of an intertrochanteric, peritrochanteric, or subtrochanteric femoral fracture using an intramedullary implant.
An orthopedic surgeon uses an intramedullary implant to stabilize a fracture in the upper femur, such as an intertrochanteric or subtrochanteric fracture. The implant is placed through the proximal femur and extends into the bone’s medullary canal; interlocking screws or cerclage may also be used. This procedure is commonly performed in a hospital operating room for patients whose fracture pattern and treatment plan call for operative stabilization.
Select this code when the operative report supports the specified fracture region and intramedullary fixation method; the implant and operative details distinguish it from plate-and-screw fixation or closed treatment. The service has 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 payment and co-surgeons are permitted; team surgery is not permitted.
CMS billing rules for 27245
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral procedure with modifier 50 is paid at 150%.
- Assistant at surgery
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU17.73 · 53%
- Practice expense (office) RVU12.04 · 36%
- Malpractice RVU3.71 · 11%
94.7K
Medicare services in 2024 · #578 by national volume
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.
27245 compared with similar codes
Office rates for Merced, from the same CMS release.
No office rate
This code reports operative intramedullary fixation. Code 27240 describes closed treatment of an intertrochanteric, peritrochanteric, or subtrochanteric fracture.
No office rate
Code 27236 is for open treatment of a femoral neck fracture. Code 27245 applies to specified intertrochanteric, peritrochanteric, or subtrochanteric fractures treated with an intramedullary implant.
The same code, a different location
How does Merced compare?
27245 across payment areas
Same release and payment basis · bars start at $0
Merced · This locality
Unavailable
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
No comparable rate is available in this setting.
Other payment areas listed in California appear first, followed by selected cross-country examples. The chart compares amounts, not distance.
The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.
Compare all 108 other payment areas
Madera
California · 27245
Office
Unavailable
Facility
$1109.44
No comparable office rate is available.
Modesto
California · 27245
Office
Unavailable
Facility
$1109.44
No comparable office rate is available.
Napa
California · 27245
Office
Unavailable
Facility
$1222.49
No comparable office rate is available.
Oxnard-Thousand Oaks-Ventura
California · 27245
Office
Unavailable
Facility
$1161.32
No comparable office rate is available.
Redding
California · 27245
Office
Unavailable
Facility
$1109.44
No comparable office rate is available.
Rest Of California
California · 27245
Office
Unavailable
Facility
$1109.44
No comparable office rate is available.
Riverside-San Bernardino-Ontario
California · 27245
Office
Unavailable
Facility
$1149.31
No comparable office rate is available.
Sacramento-Roseville-Folsom
California · 27245
Office
Unavailable
Facility
$1147.63
No comparable office rate is available.
Salinas
California · 27245
Office
Unavailable
Facility
$1143.06
No comparable office rate is available.
San Diego-Chula Vista-Carlsbad
California · 27245
Office
Unavailable
Facility
$1158.09
No comparable office rate is available.
San Francisco-Oakland-Berkeley (Marin Cnty)
California · 27245
Office
Unavailable
Facility
$1272.36
No comparable office rate is available.
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)
California · 27245
Office
Unavailable
Facility
$1268.15
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
California · 27245
Office
Unavailable
Facility
$1303.66
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
California · 27245
Office
Unavailable
Facility
$1286.43
No comparable office rate is available.
San Luis Obispo-Paso Robles
California · 27245
Office
Unavailable
Facility
$1126.73
No comparable office rate is available.
Santa Cruz-Watsonville
California · 27245
Office
Unavailable
Facility
$1159.66
No comparable office rate is available.
Santa Maria-Santa Barbara
California · 27245
Office
Unavailable
Facility
$1144.10
No comparable office rate is available.
Santa Rosa-Petaluma
California · 27245
Office
Unavailable
Facility
$1170.22
No comparable office rate is available.
Stockton
California · 27245
Office
Unavailable
Facility
$1109.44
No comparable office rate is available.
Vallejo
California · 27245
Office
Unavailable
Facility
$1216.41
No comparable office rate is available.
Visalia
California · 27245
Office
Unavailable
Facility
$1109.44
No comparable office rate is available.
Yuba City
California · 27245
Office
Unavailable
Facility
$1109.44
No comparable office rate is available.
Dc + Md/Va Suburbs
District of Columbia · 27245
Office
Unavailable
Facility
$1235.83
No comparable office rate is available.
Miami
Florida · 27245
Office
Unavailable
Facility
$1324.22
No comparable office rate is available.
Chicago
Illinois · 27245
Office
Unavailable
Facility
$1284.89
No comparable office rate is available.
Manhattan
New York · 27245
Office
Unavailable
Facility
$1293.93
No comparable office rate is available.
Alaska*
Alaska · 27245
Office
Unavailable
Facility
$1384.86
No comparable office rate is available.
Alabama
Alabama · 27245
Office
Unavailable
Facility
$1014.21
No comparable office rate is available.
Arkansas
Arkansas · 27245
Office
Unavailable
Facility
$1001.46
No comparable office rate is available.
Arizona
Arizona · 27245
Office
Unavailable
Facility
$1087.95
No comparable office rate is available.
Colorado
Colorado · 27245
Office
Unavailable
Facility
$1123.97
No comparable office rate is available.
Connecticut
Connecticut · 27245
Office
Unavailable
Facility
$1187.09
No comparable office rate is available.
Delaware
Delaware · 27245
Office
Unavailable
Facility
$1103.88
No comparable office rate is available.
Fort Lauderdale
Florida · 27245
Office
Unavailable
Facility
$1223.62
No comparable office rate is available.
Rest Of Florida
Florida · 27245
Office
Unavailable
Facility
$1162.90
No comparable office rate is available.
Atlanta
Georgia · 27245
Office
Unavailable
Facility
$1151.38
No comparable office rate is available.
Rest Of Georgia
Georgia · 27245
Office
Unavailable
Facility
$1098.62
No comparable office rate is available.
Hawaii, Guam
Hawaii · 27245
Office
Unavailable
Facility
$1121.19
No comparable office rate is available.
Iowa
Iowa · 27245
Office
Unavailable
Facility
$1009.36
No comparable office rate is available.
Idaho
Idaho · 27245
Office
Unavailable
Facility
$1020.79
No comparable office rate is available.
East St. Louis
Illinois · 27245
Office
Unavailable
Facility
$1211.74
No comparable office rate is available.
Rest Of Illinois
Illinois · 27245
Office
Unavailable
Facility
$1153.04
No comparable office rate is available.
Suburban Chicago
Illinois · 27245
Office
Unavailable
Facility
$1228.93
No comparable office rate is available.
Indiana
Indiana · 27245
Office
Unavailable
Facility
$1025.21
No comparable office rate is available.
Kansas
Kansas · 27245
Office
Unavailable
Facility
$1018.19
No comparable office rate is available.
Kentucky
Kentucky · 27245
Office
Unavailable
Facility
$1063.09
No comparable office rate is available.
New Orleans
Louisiana · 27245
Office
Unavailable
Facility
$1111.39
No comparable office rate is available.
Rest Of Louisiana
Louisiana · 27245
Office
Unavailable
Facility
$1066.81
No comparable office rate is available.
Metropolitan Boston
Massachusetts · 27245
Office
Unavailable
Facility
$1206.93
No comparable office rate is available.
Rest Of Massachusetts
Massachusetts · 27245
Office
Unavailable
Facility
$1123.90
No comparable office rate is available.
Baltimore/Surr. Cntys
Maryland · 27245
Office
Unavailable
Facility
$1186.46
No comparable office rate is available.
Rest Of Maryland
Maryland · 27245
Office
Unavailable
Facility
$1118.85
No comparable office rate is available.
Rest Of Maine
Maine · 27245
Office
Unavailable
Facility
$1039.25
No comparable office rate is available.
Southern Maine
Maine · 27245
Office
Unavailable
Facility
$1068.92
No comparable office rate is available.
Detroit
Michigan · 27245
Office
Unavailable
Facility
$1189.19
No comparable office rate is available.
Rest Of Michigan
Michigan · 27245
Office
Unavailable
Facility
$1099.26
No comparable office rate is available.
Minnesota
Minnesota · 27245
Office
Unavailable
Facility
$1042.69
No comparable office rate is available.
Metropolitan Kansas City
Missouri · 27245
Office
Unavailable
Facility
$1090.88
No comparable office rate is available.
Metropolitan St. Louis
Missouri · 27245
Office
Unavailable
Facility
$1099.21
No comparable office rate is available.
Rest Of Missouri
Missouri · 27245
Office
Unavailable
Facility
$1059.54
No comparable office rate is available.
Mississippi
Mississippi · 27245
Office
Unavailable
Facility
$1030.02
No comparable office rate is available.
Montana**
Montana · 27245
Office
Unavailable
Facility
$1118.01
No comparable office rate is available.
North Carolina
North Carolina · 27245
Office
Unavailable
Facility
$1046.58
No comparable office rate is available.
North Dakota**
North Dakota · 27245
Office
Unavailable
Facility
$1044.66
No comparable office rate is available.
Nebraska
Nebraska · 27245
Office
Unavailable
Facility
$1010.22
No comparable office rate is available.
New Hampshire
New Hampshire · 27245
Office
Unavailable
Facility
$1119.26
No comparable office rate is available.
Northern Nj
New Jersey · 27245
Office
Unavailable
Facility
$1228.34
No comparable office rate is available.
Rest Of New Jersey
New Jersey · 27245
Office
Unavailable
Facility
$1190.97
No comparable office rate is available.
New Mexico
New Mexico · 27245
Office
Unavailable
Facility
$1109.79
No comparable office rate is available.
Nevada**
Nevada · 27245
Office
Unavailable
Facility
$1097.97
No comparable office rate is available.
Nyc Suburbs/Long Island
New York · 27245
Office
Unavailable
Facility
$1338.37
No comparable office rate is available.
Poughkpsie/N Nyc Suburbs
New York · 27245
Office
Unavailable
Facility
$1209.14
No comparable office rate is available.
Queens
New York · 27245
Office
Unavailable
Facility
$1284.12
No comparable office rate is available.
Rest Of New York
New York · 27245
Office
Unavailable
Facility
$1061.35
No comparable office rate is available.
Ohio
Ohio · 27245
Office
Unavailable
Facility
$1084.27
No comparable office rate is available.
Oklahoma
Oklahoma · 27245
Office
Unavailable
Facility
$1047.60
No comparable office rate is available.
Portland
Oregon · 27245
Office
Unavailable
Facility
$1140.65
No comparable office rate is available.
Rest Of Oregon
Oregon · 27245
Office
Unavailable
Facility
$1079.85
No comparable office rate is available.
Metropolitan Philadelphia
Pennsylvania · 27245
Office
Unavailable
Facility
$1169.33
No comparable office rate is available.
Rest Of Pennsylvania
Pennsylvania · 27245
Office
Unavailable
Facility
$1078.47
No comparable office rate is available.
Puerto Rico
Puerto Rico · 27245
Office
Unavailable
Facility
$1120.83
No comparable office rate is available.
Rhode Island
Rhode Island · 27245
Office
Unavailable
Facility
$1129.40
No comparable office rate is available.
South Carolina
South Carolina · 27245
Office
Unavailable
Facility
$1069.11
No comparable office rate is available.
South Dakota**
South Dakota · 27245
Office
Unavailable
Facility
$1035.98
No comparable office rate is available.
Tennessee
Tennessee · 27245
Office
Unavailable
Facility
$1024.29
No comparable office rate is available.
Austin
Texas · 27245
Office
Unavailable
Facility
$1128.64
No comparable office rate is available.
Beaumont
Texas · 27245
Office
Unavailable
Facility
$1073.27
No comparable office rate is available.
Brazoria
Texas · 27245
Office
Unavailable
Facility
$1092.12
No comparable office rate is available.
Dallas
Texas · 27245
Office
Unavailable
Facility
$1104.39
No comparable office rate is available.
Fort Worth
Texas · 27245
Office
Unavailable
Facility
$1101.98
No comparable office rate is available.
Galveston
Texas · 27245
Office
Unavailable
Facility
$1098.87
No comparable office rate is available.
Houston
Texas · 27245
Office
Unavailable
Facility
$1166.78
No comparable office rate is available.
Rest Of Texas
Texas · 27245
Office
Unavailable
Facility
$1085.73
No comparable office rate is available.
Utah
Utah · 27245
Office
Unavailable
Facility
$1081.49
No comparable office rate is available.
Virginia
Virginia · 27245
Office
Unavailable
Facility
$1074.99
No comparable office rate is available.
Virgin Islands
United States Virgin Islands · 27245
Office
Unavailable
Facility
$1120.83
No comparable office rate is available.
Vermont
Vermont · 27245
Office
Unavailable
Facility
$1053.03
No comparable office rate is available.
Rest Of Washington
Washington · 27245
Office
Unavailable
Facility
$1117.66
No comparable office rate is available.
Seattle (King Cnty)
Washington · 27245
Office
Unavailable
Facility
$1216.48
No comparable office rate is available.
Wisconsin
Wisconsin · 27245
Office
Unavailable
Facility
$1015.62
No comparable office rate is available.
West Virginia
West Virginia · 27245
Office
Unavailable
Facility
$1118.99
No comparable office rate is available.
Wyoming**
Wyoming · 27245
Office
Unavailable
Facility
$1086.04
No comparable office rate is available.
See how rates vary across the country
27245 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.
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.
View all state and territory rates as a table
| State / territory | Rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
Where does this rate apply?
Merced is a Medicare payment area. Our Census mapping connects it to 24 cities and communities in California, including the examples shown here.
Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.
Use this rate
What is a percentage of Medicare worth?
Turn a percentage into dollars for 27245 in Merced. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$1220.38
$1109.44 × 110% = $1220.38
A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.
Working with a whole code list?
Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.
How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 27245 in Merced.
PPRRVU2026_Oct_nonQPP.csv
2,802
- Code
- 27245
- Physician work
- 17.73
- Practice expense
- 12.04
- Malpractice
- 3.71
GPCI2026.csv
15
- Locality
- Merced
- Physician work
- 1.017
- Practice expense
- 1.096
- Malpractice
- 0.536
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 17.73 | × 1.017 | 18.0314 |
| Practice expense | 12.04 | × 1.096 | 13.1958 |
| Malpractice | 3.71 | × 0.536 | 1.9886 |
| Total RVUs | 33.2158 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Merced$1109.44
Open 27245 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 17.73 | 1.017 |
| Practice expense | 12.04 | 1.096 |
| Malpractice | 3.71 | 0.536 |
(17.73 × 1.017 + 12.04 × 1.096 + 3.71 × 0.536) × $33.4009 = $1109.44
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
How this rate has changed
27245 · Office / nonfacility
Rate unavailable
Effective 2026-10-01
A rate is unavailable in one of these releases, so a change cannot be calculated.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
What changed, release by release
Explore release dates and calculate this code in an earlier period →
Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.
Inspect every release and its CMS source
| Effective from | Office / nonfacility | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $1109.44 | RVU26D |
| 2026-07-01 | Not available in this setting | $1109.44 | RVU26C |
| 2026-04-01 | Not available in this setting | $1109.44 | RVU26B |
| 2026-01-01 | Not available in this setting | $1109.44 | RVU26A |
| 2025-10-01 | Not available in this setting | $1207.41 | RVU25D |
| 2025-07-01 | Not available in this setting | $1207.41 | RVU25C |
| 2025-04-01 | Not available in this setting | $1207.41 | RVU25B |
| 2025-01-01 | Not available in this setting | $1207.41 | RVU25A |
27245 billing questions
How does this differ from code 27244?
Both address intertrochanteric, peritrochanteric, or subtrochanteric fractures. Report 27245 for intramedullary implant fixation and 27244 when the operative method uses a plate-and-screw type implant.
Can this code be used for a femoral neck fracture?
No. This code is for specified proximal femoral fracture patterns outside the femoral neck; select a femoral-neck treatment code when that is the documented fracture site.
Are related postoperative visits included?
Yes. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How is bilateral surgery reported?
For bilateral procedures, report modifier 50; CMS pays the procedure at 150%.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be made, and co-surgeons are permitted. Team surgery is not permitted for this code.
What happens when another procedure is performed in the same session?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and the other procedure or procedures 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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
2,79927238,,Treat thigh fracture,A,,5.61,6.88,NA,6.88,,1.21,13.70,13.70,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,80027240,,Treat thigh fracture,A,,13.46,10.50,NA,10.50,,2.93,26.89,26.89,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,80127244,,Treat thigh fracture,A,,17.73,12.09,NA,12.09,,3.75,33.57,33.57,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,80227245,,Treat thigh fracture,A,,17.73,12.04,NA,12.04,,3.71,33.48,33.48,0,090,0.10,0.69,0.21,2,1,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,80327246,,Treat thigh fracture,A,,4.71,7.09,,5.58,,1.01,12.81,11.30,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,80427248,,Treat thigh fracture,A,,10.51,7.81,NA,7.81,,2.21,20.53,20.53,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,80527250,,Treat hip dislocation,A,,3.72,0.61,NA,0.61,,0.90,5.23,5.23,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1201112,CA,57,HANFORD-CORCORAN,1.017,1.096,0.536
1301182,CA,18,LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY),1.041,1.183,0.664
1401112,CA,58,MADERA,1.017,1.096,0.536
1501112,CA,59,MERCED,1.017,1.096,0.536
1601112,CA,60,MODESTO,1.017,1.096,0.536
1701112,CA,51,NAPA,1.063,1.318,0.508
1801182,CA,17,OXNARD-THOUSAND OAKS-VENTURA,1.028,1.182,0.623