No office rate
Both address closed treatment of developmental hip dislocation under anesthesia. The distinguishing service for 27257 is application of a spica cast.
On this page
CMS RVU26D · Effective 2026-10-01
27256 Hip reduction Medicare reimbursement rates in Missouri
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. Compare 27256 office and facility rates across CMS payment localities in Missouri.
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 27256 in Missouri?
Missouri has 3 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 3 payment areas shown below, using the same CMS release.
Office / nonfacility
$371.24–$392.87
3 of 3 localities have a supported rate.
Facility setting
$248.87–$257.73
3 of 3 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 27256 pays more and less in Missouri
3 payment localities
$371.24 to $392.87
Orthopedic treatment
About 27256: Closed reduction of developmental hip dislocation
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.
CPT 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.
CMS billing rules for 27256
- 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 RVU4.17 · 34%
- Practice expense (office) RVU6.87 · 57%
- Malpractice RVU1.05 · 9%
30
Medicare services in 2024 · #5665 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.
27256 compared with similar codes
Office rates for Missouri, from the same CMS release.
No office rate
Use 27256 for closed manipulation under anesthesia. Use 27258 when the surgeon treats the developmental dislocation through an open approach.
No office rate
27252 concerns traumatic hip dislocation treated closed with anesthesia; 27256 is for developmental hip dislocation.
No office rate
27266 describes closed treatment under anesthesia of a dislocated hip prosthesis, not developmental hip dislocation.
Compare 27256 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.
3 of 3 payment localities
Metropolitan Kansas City →
Office / nonfacility
$389.01
Facility
$255.72
Metropolitan St. Louis →
Office / nonfacility
$392.87
Facility
$257.73
Rest Of Missouri →
Office / nonfacility
$371.24
Facility
$248.87
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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 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.
2,80627252,,Treat hip dislocation,A,,10.75,8.40,NA,8.40,,2.36,21.51,21.51,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,80727253,,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