Billing code 27259: Hip dislocationMedicare rate & RVUs in Illinois
Open surgery reduces a traumatic hip dislocation with an associated acetabular wall or femoral head fracture, including fixation when performed.
CMS doesn’t publish an office rate for 27259 in Illinois.
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 27259 covers
This code describes operative reduction of a hip dislocation when an associated fracture involves the acetabular wall, femoral head, or both. The surgeon may also stabilize the fracture with internal fixation when needed. Orthopedic trauma surgeons typically perform the procedure in an operating room for traumatic injuries requiring open management rather than closed reduction alone.
Report the code when the operative record supports both the dislocation and the associated fracture, and documents the open treatment and any fixation performed. It has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple procedure reduction. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery services may be paid; 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 27259 pays more and less in Illinois
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Chicago | Unavailable | $1,617.13 |
| East St. Louis | Unavailable | $1,525.55 |
| Rest Of Illinois | Unavailable | $1,449.42 |
| Suburban Chicago | Unavailable | $1,543.35 |
How the 27259 rate is calculated
Each of 27259’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 · 27259
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 22.68Practice expense 14.42Malpractice 4.83
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 27259
27259 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 27259
Hip dislocation
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 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) | 2 | Paid. |
| 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) | 0.10/0.69/0.21 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 27259
Hip dislocation
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.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
27259 without 50 · national facility
$1,400.50
Hip dislocation
27259-50 · Bilateral: 150%
$2,100.75
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).
27259 compared with similar codes
Compare codes
27259 vs 27253 vs 27254 vs 27265 vs 27266: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 27253Hip dislocation
- Use 27253 for open treatment of a hip dislocation without the associated acetabular wall or femoral head fracture covered here.
- 27254Hip dislocation repair
- Use 27254 for open treatment with internal fixation when the dislocation does not involve the associated fracture specified for 27259.
- 27265Hip reduction
- Use 27265 for closed treatment of a dislocated hip prosthesis without anesthesia; 27259 concerns open treatment with an associated fracture.
- 27266Hip reduction
- Use 27266 for closed treatment of a dislocated hip prosthesis requiring anesthesia, not for open treatment of a dislocation with an associated fracture.
27259 billing questions
When is this code appropriate instead of an open treatment code for hip dislocation alone?
Use this code when the hip dislocation is accompanied by an acetabular wall or femoral head fracture treated during the open procedure. Open treatment of a dislocation without that associated fracture is described by a different code.
Does the code include fracture fixation?
It includes internal fixation when performed as part of the open treatment. The operative report should identify the associated fracture and describe whether and how it was stabilized.
How does the 90-day global period affect postoperative billing?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period. The global period applies to care related to this operation.
Can modifier 50 be reported for bilateral treatment?
Yes. CMS treats this as a bilateral procedure when reported with modifier 50 and pays it at 150%.
Can an assistant-at-surgery be reported?
Assistant-at-surgery services may be paid. Co-surgeon and team-surgery reporting are not permitted for this code under the CMS rules provided.
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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