No office rate
Both codes treat a distal femoral physeal separation closed. Choose 27516 when treatment is without manipulation; 27517 represents treatment with manipulation.
On this page
CMS RVU26D · Effective 2026-10-01
27516 Growth plate fracture Medicare reimbursement rates in Alabama
Reports closed care of a separation through the distal femoral growth plate when the fracture is treated without manipulation. Compare 27516 office and facility rates across CMS payment localities in Alabama.
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.
What does Medicare pay for 27516 in Alabama?
Alabama has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$512.19
1 of 1 localities have a supported rate.
Payment area: Alabama
One mapped payment locality.
Facility setting
$428.61
1 of 1 localities have a supported rate.
Payment area: Alabama
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Orthopedic fracture care
About 27516: Closed treatment of distal femoral physeal separation
Reports closed care of a separation through the distal femoral growth plate when the fracture is treated without manipulation.
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.
CMS billing rules for 27516
- 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
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU5.45 · 32%
- Practice expense (office) RVU10.54 · 61%
- Malpractice RVU1.17 · 7%
15
Medicare services in 2024 · #6064 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.
27516 compared with similar codes
Office rates for Alabama, from the same CMS release.
No office rate
This code is for closed treatment without manipulation. 27519 is used when the distal femoral physeal separation is treated operatively through an open approach.
No office rate
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.
Compare 27516 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Alabama →
Office / nonfacility
$512.19
Facility
$428.61
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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 27516 in Alabama.
PPRRVU2026_Oct_nonQPP.csv
2,934
- Code
- 27516
- Physician work
- 5.45
- Practice expense
- 10.54
- Malpractice
- 1.17
GPCI2026.csv
4
- Locality
- Alabama
- Physician work
- 1.000
- Practice expense
- 0.875
- Malpractice
- 0.566
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 5.45 | × 1.000 | 5.4500 |
| Practice expense | 10.54 | × 0.875 | 9.2225 |
| Malpractice | 1.17 | × 0.566 | 0.6622 |
| Total RVUs | 15.3347 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Alabama$512.19
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 5.45 | 1 |
| Practice expense | 10.54 | 0.875 |
| Malpractice | 1.17 | 0.566 |
(5.45 × 1 + 10.54 × 0.875 + 1.17 × 0.566) × $33.4009 = $512.19
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 5.45 | 1 |
| Practice expense | 7.68 | 0.875 |
| Malpractice | 1.17 | 0.566 |
(5.45 × 1 + 7.68 × 0.875 + 1.17 × 0.566) × $33.4009 = $428.61
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.
27516 billing questions
When should 27516 be selected instead of 27517?
Use 27516 for closed treatment of a distal femoral growth-plate separation without manipulation. When the provider manipulates the fracture, consider 27517.
How does 27516 differ from 27510?
27516 is for a separation involving the distal femoral physis. 27510 is for closed treatment of a distal femoral fracture without manipulation that is not coded as an epiphyseal separation.
What documentation supports reporting 27516?
Document the distal femoral physeal separation, the treatment performed, and that the fracture was treated without manipulation. The record should distinguish the injury from a fracture that does not involve the growth plate.
How does the global period affect follow-up visits?
The 90-day global period includes the day-before preoperative visit and related postoperative care during the 90 days after surgery. CMS includes those services in the global surgical payment.
What happens if bilateral treatment or another procedure is reported?
With modifier 50 for bilateral treatment, CMS pays at 150%. For multiple procedures in the same session, the highest-valued procedure is paid in full and the others are subject to a 50% reduction.
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.
2,93127511,,Treatment of thigh fracture,A,,14.73,9.13,NA,9.13,,3.11,26.97,26.97,0,090,0.10,0.69,0.21,2,1,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,93227513,,Treatment of thigh fracture,A,,18.77,10.41,NA,10.41,,3.96,33.14,33.14,0,090,0.10,0.69,0.21,2,1,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,93327514,,Treatment of thigh fracture,A,,14.24,8.96,NA,8.96,,3.00,26.20,26.20,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,93427516,,Treat thigh fx growth plate,A,,5.45,10.54,,7.68,,1.17,17.16,14.30,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,93527517,,Treat thigh fx growth plate,A,,8.89,8.78,NA,8.78,,1.90,19.57,19.57,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,93627519,,Treat thigh fx growth plate,A,,12.92,8.61,NA,8.61,,2.75,24.28,24.28,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,93727520,,Treat kneecap fracture,A,,2.96,7.50,,5.74,,0.61,11.07,9.31,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1ADDENDUM E. FINAL CY 2026 GEOGRAPHIC PRACTICE COST INDICES (GPCIs) BY STATE AND MEDICARE LOCALITY,,,,,,
2,,,,,,
3Medicare Administrative Contractor (MAC),State,Locality Number,Locality Name,2026 PW GPCI (with 1.0 Floor)***,2026 PE GPCI,2026 MP GPCI
410112,AL,00,ALABAMA,1.000,0.875,0.566
502102,AK,01,ALASKA*,1.500,1.065,0.551
603102,AZ,00,ARIZONA,1.000,0.969,0.856
707102,AR,13,ARKANSAS,1.000,0.859,0.515