No office rate
Both codes concern closed reduction of a prosthetic hip dislocation. The distinction is whether anesthesia is required: 27265 is without anesthesia, while 27266 is with anesthesia.
On this page
CMS RVU26D · Effective 2026-10-01
27265 Hip reduction Medicare reimbursement rates in Rhode Island
Reports closed reduction of a dislocated hip prosthesis when the reduction is performed without anesthesia, rather than treatment of a native hip dislocation. Compare 27265 office and facility rates across CMS payment localities in Rhode Island.
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 27265 in Rhode Island?
Rhode Island 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
$501.43
1 of 1 localities have a supported rate.
Payment area: Rhode Island
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 treatment
About 27265: Closed reduction of prosthetic hip dislocation without anesthesia
Reports closed reduction of a dislocated hip prosthesis when the reduction is performed without anesthesia, rather than treatment of a native hip dislocation.
This service is the nonoperative repositioning of a dislocated hip prosthesis, restoring the prosthetic femoral component to the acetabular component without anesthesia. It is commonly performed by an orthopedic surgeon or emergency physician in a hospital or emergency department when a patient with a prior hip replacement presents with an acute prosthetic dislocation and closed reduction is appropriate. The code distinguishes this treatment from reduction requiring anesthesia and from treatment of a dislocation in a native hip.
Choose the code when the record supports a prosthetic hip dislocation and documents closed reduction without anesthesia. Include the affected side, the reduction performed, and the clinical result. Medicare assigns a 90-day global period, which includes the day-before preoperative visit and related postoperative care during the following 90 days. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple procedure reduction. For bilateral reporting with modifier 50, payment is at 150%. Medicare does not pay an assistant at surgery for this service; co-surgeons and team surgery are not permitted.
CMS billing rules for 27265
- 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
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU5.11 · 35%
- Practice expense (office) RVU8.43 · 57%
- Malpractice RVU1.23 · 8%
7.1K
Medicare services in 2024 · #1656 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.
27265 compared with similar codes
Office rates for Rhode Island, from the same CMS release.
No office rate
27250 is for closed treatment of a native hip dislocation without anesthesia. Choose 27265 when the dislocated joint is a hip prosthesis.
No office rate
27252 describes closed treatment of a native hip dislocation requiring anesthesia. It is not the prosthetic-joint code.
No office rate
27253 is open treatment of a native hip dislocation without internal fixation. 27265 describes closed reduction of a prosthetic hip dislocation.
Compare 27265 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
Rhode Island →
Office / nonfacility
Unavailable
Facility
$501.43
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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 27265 in Rhode Island.
PPRRVU2026_Oct_nonQPP.csv
2,813
- Code
- 27265
- Physician work
- 5.11
- Practice expense
- 8.43
- Malpractice
- 1.23
GPCI2026.csv
92
- Locality
- Rhode Island
- Physician work
- 1.019
- Practice expense
- 1.033
- Malpractice
- 0.892
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 5.11 | × 1.019 | 5.2071 |
| Practice expense | 8.43 | × 1.033 | 8.7082 |
| Malpractice | 1.23 | × 0.892 | 1.0972 |
| Total RVUs | 15.0124 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Rhode Island$501.43
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 5.11 | 1.019 |
| Practice expense | 8.43 | 1.033 |
| Malpractice | 1.23 | 0.892 |
(5.11 × 1.019 + 8.43 × 1.033 + 1.23 × 0.892) × $33.4009 = $501.43
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.
27265 billing questions
When should 27265 be chosen over 27266?
Use 27265 for closed reduction of a prosthetic hip dislocation without anesthesia. Use 27266 when the reduction requires anesthesia.
Does this code describe reduction of a native hip dislocation?
No. It is for a dislocated hip prosthesis. Codes 27250 and 27252 address closed treatment of native hip dislocations, distinguished by anesthesia status.
What documentation supports reporting 27265?
Document the prosthetic hip dislocation, the closed reduction, the affected side, and that the service was performed without anesthesia.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and related postoperative care during the 90 days after the procedure.
How is bilateral treatment reported under the CMS facts?
When both hips are treated in the same session, modifier 50 is paid at 150% under the stated CMS bilateral rule.
Can an assistant or co-surgeon be reported for this procedure?
Medicare does not pay an assistant at surgery for this service. 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.
2,81027257,,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
2,81427266,,Treat hip dislocation,A,,7.59,7.49,NA,7.49,,1.62,16.70,16.70,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,81527267,,Cltx thigh fx,A,,5.36,6.43,NA,6.43,,1.12,12.91,12.91,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,81627268,,Cltx thigh fx w/mnpj,A,,6.94,7.05,NA,7.05,,1.47,15.46,15.46,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
8912502,PA,01,METROPOLITAN PHILADELPHIA,1.018,1.041,1.193
9012502,PA,99,REST OF PENNSYLVANIA,1.000,0.918,0.945
9109202,PR,20,PUERTO RICO,1.000,1.011,0.985
9214412,RI,01,RHODE ISLAND,1.019,1.033,0.892
9311202,SC,01,SOUTH CAROLINA,1.000,0.924,0.850
9403402,SD,02,SOUTH DAKOTA**,1.000,1.000,0.336
9510312,TN,35,TENNESSEE,1.000,0.909,0.537