No office rate
Use 27235 for percutaneous fixation of an established proximal femoral neck fracture. Use 27187 when the surgeon reinforces a weakened neck before fracture.
On this page
CMS RVU26D · Effective 2026-10-01
27187 Femoral neck reinforcement Medicare reimbursement rates in Vermont
Reports surgical reinforcement of a weakened femoral neck to reduce fracture risk, such as when a bone lesion compromises its strength. Compare 27187 office and facility rates across CMS payment localities in Vermont.
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 27187 in Vermont?
Vermont 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
$867.77
1 of 1 localities have a supported rate.
Payment area: Vermont
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 27187: Prophylactic femoral neck reinforcement
Reports surgical reinforcement of a weakened femoral neck to reduce fracture risk, such as when a bone lesion compromises its strength.
An orthopedic surgeon reinforces a femoral neck that is weakened and at risk of fracture, rather than treating a fracture that has already occurred. The procedure may involve reinforcement with or without methyl methacrylate. A typical setting is a hospital operating room, often for a patient whose femoral neck has been compromised by a bone lesion, such as metastatic disease.
Select this code when the operative service is preventive reinforcement of the femoral neck. The operative report should identify the treated side and site, explain the structural problem and fracture risk, and describe the reinforcement performed. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to a 50% reduction. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 27187
- 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 RVU13.87 · 50%
- Practice expense (office) RVU10.73 · 39%
- Malpractice RVU2.94 · 11%
1.5K
Medicare services in 2024 · #2662 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.
27187 compared with similar codes
Office rates for Vermont, from the same CMS release.
No office rate
Use 27236 for open treatment of an established proximal femoral neck fracture, including internal fixation or prosthetic replacement. Code 27187 describes preventive reinforcement.
No office rate
27170 addresses repair or grafting involving the femoral head or neck. Choose 27187 when the documented purpose is prophylactic reinforcement of a fracture-prone femoral neck.
No office rate
27130 reports total hip replacement. It is not the code for reinforcing a femoral neck while retaining the hip joint.
Compare 27187 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
Vermont →
Office / nonfacility
Unavailable
Facility
$867.77
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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 27187 in Vermont.
PPRRVU2026_Oct_nonQPP.csv
2,781
- Code
- 27187
- Physician work
- 13.87
- Practice expense
- 10.73
- Malpractice
- 2.94
GPCI2026.csv
105
- Locality
- Vermont
- Physician work
- 1.000
- Practice expense
- 0.990
- Malpractice
- 0.506
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 13.87 | × 1.000 | 13.8700 |
| Practice expense | 10.73 | × 0.990 | 10.6227 |
| Malpractice | 2.94 | × 0.506 | 1.4876 |
| Total RVUs | 25.9803 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Vermont$867.77
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 13.87 | 1 |
| Practice expense | 10.73 | 0.99 |
| Malpractice | 2.94 | 0.506 |
(13.87 × 1 + 10.73 × 0.99 + 2.94 × 0.506) × $33.4009 = $867.77
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.
27187 billing questions
When should I report 27187 instead of a femoral neck fracture code?
Report 27187 for preventive reinforcement of a weakened femoral neck at risk of fracture. If the surgeon treats an established femoral neck fracture, consider the fracture-treatment code that matches the procedure performed, such as 27235 or 27236.
Does 27187 include methyl methacrylate?
The service may include reinforcement with or without methyl methacrylate. The operative report should describe the technique used.
What documentation supports 27187?
Document the femoral neck and side treated, the condition weakening the bone, the risk of fracture, and the preventive reinforcement performed. The record should make clear whether a fracture was already present.
How does the 90-day global period affect postoperative billing?
The CMS global period includes the day-before preoperative visit and 90 days of related postoperative care. These services are included in the global surgical package.
How is bilateral 27187 paid?
CMS identifies this as a bilateral procedure; reporting modifier 50 is paid at 150%.
What happens when 27187 is performed with another procedure in the same session?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and the other procedures are paid at 50%. Assistant-at-surgery payment may be made; co-surgeons require supporting documentation, and team surgery is 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.
2,77827179,,Revise head/neck of femur,A,,13.62,10.53,NA,10.53,,2.91,27.06,27.06,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,77927181,,Treat slipped epiphysis,A,,15.78,11.78,NA,11.78,,3.35,30.91,30.91,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,78027185,,Revision of femur epiphysis,A,,9.55,8.68,NA,8.68,,2.04,20.27,20.27,0,090,0.10,0.69,0.21,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,78127187,,Reinforce hip bones,A,,13.87,10.73,NA,10.73,,2.94,27.54,27.54,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,78227197,,Clsd tx pelvic ring fx,A,,1.49,1.91,NA,1.91,,0.30,3.70,3.70,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,78327198,,Clsd tx pelvic ring fx,A,,4.63,2.89,NA,2.89,,0.99,8.51,8.51,0,000,0.00,0.00,0.00,2,0,0,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,78427200,,Treat tail bone fracture,A,,1.87,4.12,,3.75,,0.39,6.38,6.01,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
10204412,TX,18,HOUSTON,1.008,0.993,1.376
10304412,TX,99,REST OF TEXAS,1.000,0.949,0.903
10403502,UT,09,UTAH,1.000,0.940,0.898
10514512,VT,50,VERMONT,1.000,0.990,0.506
10611302,VA,00,VIRGINIA,1.000,0.983,0.706
10709202,VI,50,VIRGIN ISLANDS,1.000,1.011,0.985
10802402,WA,02,SEATTLE (KING CNTY),1.050,1.227,0.817