No office rate
Both describe closed treatment of a femoral head fracture. Choose 27268 when manipulation is performed; choose 27267 when it is not.
On this page
CMS RVU26D · Effective 2026-10-01
27268 Femoral head fracture Medicare reimbursement rates in Wyoming
Reports closed treatment of a femoral head fracture when the physician manipulates the fracture, with or without skeletal traction. Compare 27268 office and facility rates across CMS payment localities in Wyoming.
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 27268 in Wyoming?
Wyoming 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
$503.61
1 of 1 localities have a supported rate.
Payment area: Wyoming**
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 fracture care
About 27268: Closed femoral head fracture treatment with manipulation
Reports closed treatment of a femoral head fracture when the physician manipulates the fracture, with or without skeletal traction.
An orthopedic surgeon typically performs this closed treatment in a hospital or surgical facility, often under anesthesia. The physician manipulates the femoral head fracture without surgically exposing it; skeletal traction may also be used. Femoral head fractures can occur with hip dislocation, but this service addresses the fracture rather than the dislocation itself.
Select this code when documentation supports a femoral head fracture and manipulation as part of its treatment. The record should identify the fracture site and describe the reduction or other manipulation performed; imaging and documentation of traction, if used, can support the service. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care. For multiple procedures in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple procedure reduction. Modifier 50 indicates bilateral treatment, paid at 150%. An assistant at surgery may be paid; co-surgeons require supporting documentation, and team surgery is not permitted.
CMS billing rules for 27268
- 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 RVU6.94 · 45%
- Practice expense (office) RVU7.05 · 46%
- Malpractice RVU1.47 · 10%
21
Medicare services in 2024 · #5889 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.
27268 compared with similar codes
Office rates for Wyoming, from the same CMS release.
No office rate
This code describes open treatment of a femoral head fracture. Use 27268 for closed treatment with manipulation.
No office rate
This code addresses closed treatment of a hip dislocation requiring anesthesia, not manipulation of a femoral head fracture. Identify which injury the documented service treats.
Compare 27268 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
Wyoming** →
Office / nonfacility
Unavailable
Facility
$503.61
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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 27268 in Wyoming**.
PPRRVU2026_Oct_nonQPP.csv
2,816
- Code
- 27268
- Physician work
- 6.94
- Practice expense
- 7.05
- Malpractice
- 1.47
GPCI2026.csv
112
- Locality
- Wyoming**
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.740
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 6.94 | × 1.000 | 6.9400 |
| Practice expense | 7.05 | × 1.000 | 7.0500 |
| Malpractice | 1.47 | × 0.740 | 1.0878 |
| Total RVUs | 15.0778 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Wyoming**$503.61
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 6.94 | 1 |
| Practice expense | 7.05 | 1 |
| Malpractice | 1.47 | 0.74 |
(6.94 × 1 + 7.05 × 1 + 1.47 × 0.74) × $33.4009 = $503.61
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.
27268 billing questions
How does this differ from 27267?
Use 27268 when the physician manipulates the femoral head fracture. Code 27267 describes closed treatment without manipulation.
When is 27269 more appropriate?
Use 27269 for open treatment of a femoral head fracture. Code 27268 describes closed treatment with manipulation, without surgically exposing the fracture.
Does this code cover reduction of an associated hip dislocation?
The code describes treatment of the femoral head fracture, not the hip dislocation. If a dislocation is also treated, document that service separately and determine the appropriate reporting under applicable coding rules.
What documentation supports reporting 27268?
Document the femoral head fracture and the manipulation performed to treat it. Note skeletal traction when used, along with relevant imaging and treatment details.
How does the 90-day global period affect postoperative visits?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
Can modifier 50 or an assistant-at-surgery claim apply?
CMS treats this as a bilateral procedure when modifier 50 is reported, with payment at 150%. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation.
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.
2,81327265,,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
2,81727269,,Optx thigh fx,A,,18.42,11.26,NA,11.26,,3.89,33.57,33.57,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,81827275,,Manipulation of hip joint,A,,2.26,2.63,NA,2.63,,0.46,5.35,5.35,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,81927278,,Arthrd si jt plmt iartic dev,A,,7.66,403.30,,4.64,,0.85,411.81,13.15,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
10902402,WA,99,REST OF WASHINGTON,1.013,1.053,0.761
11011402,WV,16,WEST VIRGINIA,1.000,0.869,1.431
11106302,WI,00,WISCONSIN,1.000,0.958,0.308
11203602,WY,21,WYOMING**,1.000,1.000,0.740
113"MAC Assignments as of November 22, 2023",,,,,,
114,,,,,,
115*Work GPCI reflects a 1.5 floor in Alaska established by the MIPPA.,,,,,,