$564.53–$626.80
27516 is a closed-treatment option for distal femoral epiphyseal separation. Choose 27519 when the surgeon uses an open approach.
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CMS RVU26D · Effective 2026-10-01
27519 Physeal fracture repair Medicare reimbursement rates in Illinois
Reports open surgical treatment of a distal femoral growth plate separation, with internal fixation included when performed. Compare 27519 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 27519 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
$837.67–$934.38
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 27519 pays more and less in Illinois
Orthopedic surgery
About 27519: Open treatment of distal femoral physeal fracture
Reports open surgical treatment of a distal femoral growth plate separation, with internal fixation included when performed.
This service treats a separation or fracture through the growth plate at the lower end of the femur using open surgery. The orthopedic surgeon exposes the injury, restores alignment, and uses fixation when needed. It is most often performed in an operating room for a child or adolescent with a distal femoral physeal injury; the operative record should establish that the fracture involves the growth plate.
Report this code when the surgeon performs open treatment of the distal femoral epiphyseal separation, rather than treating it closed. Document the fracture location and physeal involvement, the open reduction, and any fixation performed. The code has a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When multiple procedures occur in one session, the highest-valued procedure is paid in full and other procedures at 50%. Bilateral reporting with modifier 50 is paid at 150%. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 27519
- 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 paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU12.92 · 53%
- Practice expense (office) RVU8.61 · 35%
- Malpractice RVU2.75 · 11%
28
Medicare services in 2024 · #5702 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.
27519 compared with similar codes
Office rates for Illinois, from the same CMS release.
No office rate
27517 also describes closed treatment of distal femoral epiphyseal separation; 27519 describes open treatment.
No office rate
Use 27511 for the distal femoral fracture pattern specified by that code when the injury is not a physeal separation.
No office rate
27513 is for a distal femoral supracondylar or transcondylar fracture with intercondylar extension, not a growth plate separation.
Compare 27519 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
$934.38
East St. Louis →
Office / nonfacility
Unavailable
Facility
$881.11
Rest Of Illinois →
Office / nonfacility
Unavailable
Facility
$837.67
Suburban Chicago →
Office / nonfacility
Unavailable
Facility
$892.67
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27519 billing questions
How does this differ from 27516 or 27517?
Those codes describe closed treatment options for a distal femoral epiphyseal separation. Use 27519 when the surgeon treats the separation through an open approach.
Is internal fixation included?
Yes. Fixation, when performed as part of the open treatment, is included in this service.
What documentation supports reporting this code?
The operative report should identify the distal femoral growth plate injury and describe open treatment, including reduction and any fixation performed.
Does the code include postoperative care?
The 90-day global period includes the day-before preoperative visit and related postoperative care during the 90 days after surgery.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
How is bilateral treatment handled?
When the procedure is performed bilaterally and reported with modifier 50, CMS pays the code at 150%.
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.
2,93327514,,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
2,93827524,,Treat kneecap fracture,A,,10.11,8.89,NA,8.89,,2.11,21.11,21.11,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,93927530,,Treat knee fracture,A,,2.58,7.34,,5.90,,0.53,10.45,9.01,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00