Billing code 27256: Hip reductionMedicare rate & RVUs in Guam
Reports closed manipulation under anesthesia to reduce a developmentally dislocated hip when treatment does not include the spica-cast service represented by its sibling code.
Medicare pays $420.49 for 27256 in the office in Guam (Hawaii, Guam). Which amount applies depends on the service address.
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 9 sections
What 27256 covers
billing code 27256 represents closed manipulation under anesthesia to reposition a hip affected by developmental dislocation, often in a young child with developmental dysplasia of the hip. A pediatric orthopedic surgeon typically performs the reduction in an operating room or another setting where anesthesia is provided. The procedure uses a closed approach rather than surgically exposing the joint. The related code 27257 distinguishes treatment that includes application of a spica cast.
Select 27256 when the documented diagnosis and treatment are for developmental hip dislocation and the surgeon performs closed manipulation under anesthesia. The operative report should identify the affected hip, the closed reduction, and the use of anesthesia; distinguish the service from traumatic dislocation treatment and open reduction. CMS includes related postoperative visits for 10 days in the global period. For bilateral treatment, modifier 50 is paid at 150%. When multiple procedures occur in one session, the highest-valued procedure is paid in full and others at 50%. An assistant is paid only with documented medical necessity; 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.
27256 in Hawaii, Guam
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam | $420.49 | $259.09 |
How the 27256 rate is calculated
Each of 27256’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 · 27256
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 4.17Practice expense 6.87Malpractice 1.05
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 27256
27256 has a 10-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 27256
Hip reduction
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 010 | Minor procedure: the day of the procedure plus 10 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.80/0.10 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 27256
Hip reduction
10-day global period ends
Oct 11, 2026
Covers Oct 1, 2026 through Oct 11, 2026 (11 days).
Visit on Oct 31, 2026
After the global period ends: visits and procedures are billed normally.
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
27256 without 50 · national office
$403.82
Hip reduction
27256-50 · Bilateral: 150%
$605.73
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).
27256 compared with similar codes
Compare codes
27256 vs 27257 vs 27258 vs 27252 vs 27266: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 27257Hip reduction
- Both address closed treatment of developmental hip dislocation under anesthesia. The distinguishing service for 27257 is application of a spica cast.
- 27258Hip dislocation
- Use 27256 for closed manipulation under anesthesia. Use 27258 when the surgeon treats the developmental dislocation through an open approach.
- 27252Hip reduction
- 27252 concerns traumatic hip dislocation treated closed with anesthesia; 27256 is for developmental hip dislocation.
- 27266Hip reduction
- 27266 describes closed treatment under anesthesia of a dislocated hip prosthesis, not developmental hip dislocation.
27256 billing questions
How is 27256 different from 27257?
Both concern closed treatment of developmental hip dislocation under anesthesia. Use 27257 when the service includes application of a spica cast; 27256 identifies the closed manipulation without that cast service.
Can 27256 be used for a traumatic hip dislocation?
No. This code is for developmental dislocation. Traumatic hip dislocations are reported from the separate traumatic hip-dislocation code family according to the treatment performed.
What documentation supports 27256?
Document developmental hip dislocation, the closed manipulation and reduction under anesthesia, and the side treated. The record should make clear that the surgeon did not use an open approach.
How should bilateral treatment be reported?
CMS identifies this as a bilateral procedure; report modifier 50 for bilateral treatment. CMS payment for the bilateral procedure is 150%.
Are postoperative visits separately payable?
Related postoperative visits during the 10-day global period are included in the procedure payment.
Can an assistant or co-surgeon be reported?
An assistant at surgery is paid only when medical necessity is documented. Co-surgeons and team surgery are not permitted for this code.
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
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