Billing code 27238: Femoral fracture careMedicare rate & RVUs in Texas
Reports nonoperative management of a femoral shaft fracture when the provider treats the fracture without manipulating the fragments.
CMS doesn’t publish an office rate for 27238 in Texas.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 27238 covers
This code describes closed management of a fracture through the femoral shaft without manipulating the fracture fragments. An orthopedic surgeon or other qualified physician may use this approach when the fracture can be managed without operative fixation, maintaining alignment with appropriate nonoperative care such as immobilization or traction. Treatment may occur in a hospital or another setting where the physician establishes and directs the fracture-care plan.
Select the code when documentation supports a femoral shaft fracture and confirms treatment without manipulation; distinguish it from care involving manipulation or surgical fixation. The record should identify the fracture site, treatment plan, and whether the fragments were manipulated. Medicare 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%. Medicare does not pay an assistant at surgery; co-surgeons and team surgery are not permitted.
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.
Where 27238 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | Unavailable | $466.69 |
| Beaumont | Unavailable | $434.04 |
| Brazoria | Unavailable | $448.13 |
| Dallas | Unavailable | $452.62 |
| Fort Worth | Unavailable | $450.85 |
| Galveston | Unavailable | $450.53 |
| Houston | Unavailable | $472.68 |
| Rest Of Texas | Unavailable | $441.95 |
How the 27238 rate is calculated
Each of 27238’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 27238
RVUs × geographic indexes × conversion factor
Work5.61
5.61 RVUs× 1.000 GPCI
Practice expense6.88
6.88 RVUs× 1.000 GPCI
Malpractice1.21
1.21 RVUs× 1.000 GPCI
Adjusted RVUs
13.7000
Conversion factor
$33.4009
Medicare rate
$457.59
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 27238
27238 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 27238
Femoral fracture care
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.69/0.21 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 27238
Femoral fracture care
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
27238 without 50 · national facility
$457.59
Femoral fracture care
27238-50 · Bilateral: 150%
$686.39
Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).
27238 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 27240Femoral fracture care
- Both address closed treatment of a femoral shaft fracture; 27240 involves manipulation, while 27238 does not.
- 27244Femur fracture repair
- Use 27244 for open treatment of a femoral shaft fracture, not closed treatment without manipulation.
- 27245Femur fracture fixation
- Use 27245 when the femoral shaft fracture is treated with an intramedullary implant.
- 27230Fracture treatment
- Code 27230 concerns a femoral neck fracture treated without manipulation; 27238 is for the femoral shaft.
27238 billing questions
How does this differ from 27240?
Use 27238 when the femoral shaft fracture is treated without manipulating the fragments. Code 27240 is for closed treatment with manipulation.
Are routine fracture follow-up visits included?
Yes. The 90-day global period includes related postoperative care, along with the day-before preoperative visit.
Can modifier 50 be used for bilateral femoral shaft fractures?
CMS identifies this as a bilateral procedure; reporting modifier 50 is paid at 150%.
Can an assistant or co-surgeon be reported?
Medicare does not pay an assistant at surgery for this code. Co-surgeons and team surgery are not permitted.
What documentation supports reporting 27238?
Document the femoral shaft fracture, the closed treatment plan, and that the fracture fragments were not manipulated.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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