$375.37
Both address closed treatment of developmental hip dislocation; 27257 is selected when anesthesia is required, while 27256 is for treatment without anesthesia.
On this page
CMS RVU26D · Effective 2026-10-01
27257 Hip reduction Medicare reimbursement rates in Kentucky
Reports closed treatment of a unilateral developmental hip dislocation when reduction is performed under anesthesia, commonly by an orthopedic surgeon. Compare 27257 office and facility rates across CMS payment localities in Kentucky.
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 27257 in Kentucky?
Kentucky 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
No supported rate
Facility setting
$313.51
1 of 1 localities have a supported rate.
Payment area: Kentucky
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 surgery
About 27257: Developmental hip dislocation reduction under anesthesia
Reports closed treatment of a unilateral developmental hip dislocation when reduction is performed under anesthesia, commonly by an orthopedic surgeon.
This code describes closed treatment of a developmental hip dislocation with the patient under anesthesia. A pediatric orthopedic surgeon commonly performs the reduction in an operating room, often for an infant or young child whose hip requires manipulation under anesthesia. The approach remains closed; an open reduction or an operation that includes an osteotomy belongs to a different code selection.
Choose this code when documentation identifies a developmental dislocation and supports closed reduction under anesthesia; the code distinguishes this service from closed treatment without anesthesia and from treatment of a traumatic dislocation. Document the affected side, diagnosis, and reduction performed. The 10-day global period includes related postoperative visits during that period. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are reduced to 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.
CMS billing rules for 27257
- Global period
- Minor procedure with a 10-day global period: related postoperative visits for 10 days 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 is paid only with documentation of medical necessity.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU5.25 · 53%
- Practice expense (office) RVU3.50 · 35%
- Malpractice RVU1.12 · 11%
51
Medicare services in 2024 · #5340 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.
27257 compared with similar codes
Office rates for Kentucky, from the same CMS release.
No office rate
This code covers developmental dislocation. Code 27252 covers closed treatment of traumatic hip dislocation requiring anesthesia.
No office rate
Use 27257 for a closed reduction under anesthesia. Code 27258 is for open treatment of developmental hip dislocation.
No office rate
Code 27259 describes open treatment with femoral and/or pelvic osteotomy; 27257 is closed treatment without osteotomy.
Compare 27257 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
Kentucky →
Office / nonfacility
Unavailable
Facility
$313.51
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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 27257 in Kentucky.
PPRRVU2026_Oct_nonQPP.csv
2,810
- Code
- 27257
- Physician work
- 5.25
- Practice expense
- 3.50
- Malpractice
- 1.12
GPCI2026.csv
55
- Locality
- Kentucky
- Physician work
- 1.000
- Practice expense
- 0.889
- Malpractice
- 0.915
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 5.25 | × 1.000 | 5.2500 |
| Practice expense | 3.50 | × 0.889 | 3.1115 |
| Malpractice | 1.12 | × 0.915 | 1.0248 |
| Total RVUs | 9.3863 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Kentucky$313.51
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 5.25 | 1 |
| Practice expense | 3.5 | 0.889 |
| Malpractice | 1.12 | 0.915 |
(5.25 × 1 + 3.5 × 0.889 + 1.12 × 0.915) × $33.4009 = $313.51
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.
27257 billing questions
Can this code be used for a traumatic hip dislocation?
No. This code is for developmental dislocation. Codes 27250 and 27252 address closed treatment of traumatic hip dislocation, with anesthesia status distinguishing the selection.
What documentation supports reporting this code?
Document the developmental dislocation, the affected side, and the closed reduction performed under anesthesia. The record should make clear that treatment was not an open reduction.
How should bilateral treatment be reported?
For bilateral treatment, report modifier 50; CMS pays the bilateral procedure at 150%.
Are related postoperative visits included?
Yes. Related postoperative visits during the 10-day global period are included.
Can an assistant surgeon be paid for this procedure?
Assistant-at-surgery payment is allowed only when medical necessity is documented. Co-surgeons and team surgery are not permitted.
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.
2,80727253,,Treat hip dislocation,A,,13.24,9.97,NA,9.97,,2.83,26.04,26.04,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,80827254,,Treat hip dislocation,A,,18.47,12.24,NA,12.24,,3.93,34.64,34.64,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,80927256,,Treat hip dislocation,A,,4.17,6.87,,2.62,,1.05,12.09,7.84,0,010,0.10,0.80,0.10,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,81027257,,Treat hip dislocation,A,,5.25,3.50,NA,3.50,,1.12,9.87,9.87,0,010,0.10,0.80,0.10,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,81127258,,Treat hip dislocation,A,,15.78,11.38,NA,11.38,,3.35,30.51,30.51,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,81227259,,Treat hip dislocation,A,,22.68,14.42,NA,14.42,,4.83,41.93,41.93,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,81327265,,Treat hip dislocation,A,,5.11,8.43,NA,8.43,,1.23,14.77,14.77,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915
5607202,LA,01,NEW ORLEANS,1.000,0.941,1.136
5707202,LA,99,REST OF LOUISIANA,1.000,0.885,0.958
5814112,ME,03,SOUTHERN MAINE,1.000,0.991,0.631