Billing code 27269: Femoral fracture repairMedicare rate & RVUs in Washington
Openly treats a proximal femoral neck fracture with an associated hip dislocation, using internal fixation or prosthetic replacement when indicated.
CMS doesn’t publish an office rate for 27269 in Washington.
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 27269 covers
This code describes open surgical treatment of a fracture at the proximal femur’s neck when the injury is accompanied by a hip dislocation. The surgeon exposes the injury, addresses the dislocation, and treats the fracture with internal fixation or prosthetic replacement as clinically indicated. These cases are typically managed by an orthopedic surgeon in a hospital operating room or other facility setting.
Report the code when the operative documentation supports both the proximal femoral neck fracture and associated hip dislocation, along with the open treatment performed. The record should identify the fracture and dislocation and describe the reduction and fracture treatment. Medicare assigns a 90-day global period, which includes the day-before preoperative visit and 90 days of related postoperative care. 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 multiple procedure reduction. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be available; co-surgeons require supporting documentation, and team surgery is 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 27269 pays more and less in Washington
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Washington | Unavailable | $1,118.15 |
| Seattle (King Cnty) | Unavailable | $1,213.63 |
How the 27269 rate is calculated
Each of 27269’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 · 27269
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 18.42Practice expense 11.26Malpractice 3.89
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 27269
27269 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 27269
Femoral fracture repair
| 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) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| 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 · 27269
Femoral fracture repair
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
27269 without 50 · national facility
$1,121.27
Femoral fracture repair
27269-50 · Bilateral: 150%
$1,681.91
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).
27269 compared with similar codes
Compare codes
27269 vs 27236 vs 27267 vs 27268 vs 27253: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 27236Femoral neck repair
- Use 27269 when the proximal femoral neck fracture is associated with a hip dislocation. Use 27236 for the open fracture treatment without that associated dislocation.
- 27267Fracture treatment
- 27267 describes closed treatment without manipulation. This code describes open treatment of a fracture with an associated hip dislocation.
- 27268Femoral head fracture
- 27268 describes closed treatment with manipulation. It is not the open fracture-and-dislocation treatment described by 27269.
- 27253Hip dislocation
- 27253 addresses open treatment of traumatic hip dislocation. This code is for open treatment when a proximal femoral neck fracture accompanies the dislocation.
27269 billing questions
How does this differ from 27236?
This code is for open treatment of a proximal femoral neck fracture with an associated hip dislocation. Use 27236 for the corresponding open fracture treatment when the associated dislocation is not part of the case.
Can the hip dislocation treatment be reported separately?
The code describes open treatment of the fracture with the associated hip dislocation. Review the operative report and applicable coding guidance before considering a separate dislocation code for work included in this service.
What documentation supports reporting this code?
Document the proximal femoral neck fracture, the associated hip dislocation, and the open treatment performed. Include whether the fracture was treated with internal fixation or prosthetic replacement.
How does the 90-day global affect postoperative billing?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period. The period begins around the surgery and encompasses routine related follow-up.
How are other procedures in the same session paid?
For same-session multiple procedures, Medicare pays the highest-valued procedure in full and applies the standard multiple procedure reduction to the others. Modifier 50 bilateral reporting is paid at 150%.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be available. Co-surgeons are paid only with supporting documentation; 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 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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