No office rate
Choose 27511 for an open-treated fracture limited to a medial or lateral femoral condyle; 27513 is for a supracondylar or transcondylar pattern, with or without intercondylar extension.
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CMS RVU26D · Effective 2026-10-01
27513 Distal femur repair Medicare reimbursement rates in Illinois
Reports operative repair of a distal femoral fracture above or through the condyles, including patterns with intercondylar extension and fixation when performed. Compare 27513 office and facility rates across CMS payment localities in Illinois.
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 27513 in Illinois?
Illinois has 4 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 4 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$1151.12–$1284.32
4 of 4 localities have a supported rate.
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.
Where 27513 pays more and less in Illinois
Fracture treatment
About 27513: Open repair of distal femoral fracture
Reports operative repair of a distal femoral fracture above or through the condyles, including patterns with intercondylar extension and fixation when performed.
An orthopedic surgeon uses this service to repair a supracondylar or transcondylar fracture at the lower end of the femur. The fracture may extend between the condyles into the knee joint. The operation involves open reduction; internal fixation is included when performed. These repairs are typically done in an operating room, often for displaced distal femur fractures that need operative stabilization.
Select the code based on the documented fracture pattern and operative treatment, distinguishing it from a fracture confined to a medial or lateral condyle or from a shaft fracture. The operative report should identify the distal femoral fracture pattern and describe the open repair and fixation performed. CMS assigns 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 27513
- 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 RVU18.77 · 57%
- Practice expense (office) RVU10.41 · 31%
- Malpractice RVU3.96 · 12%
3K
Medicare services in 2024 · #2183 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.
27513 compared with similar codes
Office rates for Illinois, from the same CMS release.
No office rate
27509 describes percutaneous skeletal fixation of a distal femoral condylar fracture. This code is for open repair of a supracondylar or transcondylar fracture.
No office rate
27506 concerns open treatment of a femoral shaft fracture with an intramedullary implant. Use 27513 for the specified fracture pattern at the distal end of the femur.
Compare 27513 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.
4 of 4 payment localities
Chicago →
Office / nonfacility
Unavailable
Facility
$1284.32
East St. Louis →
Office / nonfacility
Unavailable
Facility
$1213.21
Rest Of Illinois →
Office / nonfacility
Unavailable
Facility
$1151.12
Suburban Chicago →
Office / nonfacility
Unavailable
Facility
$1222.79
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27513 billing questions
How is this code distinguished from 27511?
Use 27513 for a supracondylar or transcondylar distal femur fracture, with or without intercondylar extension. Code 27511 describes open treatment of a fracture confined to a medial or lateral condyle.
Is internal fixation included?
Yes. Internal fixation, when performed as part of the open fracture repair, is included in this service.
Can an assistant surgeon or co-surgeon be reported?
CMS permits assistant-at-surgery payment and co-surgeons for this code. Team-surgery billing is not permitted.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How does CMS handle bilateral reporting?
When the service is performed bilaterally, report modifier 50; CMS pays it at 150%.
How are other procedures in the same session paid?
Under the standard multiple procedure reduction, CMS pays the highest-valued procedure in full and other procedures 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.
2,92927509,,Treatment of thigh fracture,A,,7.94,9.94,NA,9.94,,1.66,19.54,19.54,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,93027510,,Treatment of thigh fracture,A,,9.56,8.45,NA,8.45,,2.13,20.14,20.14,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,93127511,,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