Closed treatment of a supracondylar or transcondylar femoral fracture, with or without intercondylar extension, performed without manipulation.

Verified May 8, 2026 · 4 sources ↓

Medicare: $550.45
Work RVU: 6.29
Global, days: 90
Region: Knee

Drawn from EmednyCMSFindacode

Documentation requirements

What must appear in the operative or office note to support the claim.

Source · Editorial brief grounded in 4 cited references ↓

Imaging report (X-ray or CT) confirming supracondylar, transcondylar, or intercondylar extension fracture pattern
Explicit documentation that no manipulation was performed or attempted
Laterality clearly stated (left vs. right femur)
Treatment rationale — why closed non-manipulative management was appropriate (e.g., acceptable alignment, patient factors)
Type of immobilization applied (cast, splint, brace) and clinical rationale for that choice
Neurovascular status assessment of the affected limb documented at the time of treatment

Applicable modifiers

Modifiers commonly billed with this code.

Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual

22 Increased complexity 24 Unrelated E/M during global 25 Significant separate E/M 50 Bilateral procedure 51 Multiple procedures 52 Reduced services 57 Decision for surgery 58 Staged or related 59 Distinct service 76 Repeat, same physician 77 Repeat, another physician 78 Unplanned return — related 79 Unrelated during global 80 Assistant surgeon AS PA/NP/CNS assistant LT Left side RT Right side

What this code covers

Source · Editorial summary grounded in 4 cited references ↓

CPT 27501 covers closed (non-operative) management of a supracondylar or transcondylar distal femur fracture — including those with intercondylar extension — where no manipulation is required to achieve acceptable alignment. The fracture is treated non-surgically, typically with immobilization such as a cast, splint, or brace. Because the physician assumes follow-up care, casting and splinting codes are bundled into 27501 and cannot be billed separately per NCCI policy.

The 90-day global period covers the day-before visit, the treatment encounter, and all routine post-fracture management through day 90. Any unrelated E/M visit or procedure during that window requires modifier 24 or 79, respectively. If a planned staged procedure becomes necessary — for example, escalation to surgical fixation — bill the subsequent procedure with modifier 58.

Diagnosis coding must specify the fracture type (supracondylar vs. transcondylar), laterality, and encounter type (initial vs. subsequent vs. sequela) using the appropriate ICD-10-CM S72 subcategory. Payers routinely reject claims where the ICD-10 specificity doesn't match the CPT code's anatomic level.

RVU & reimbursement

Component RVUs and Medicare national rate. Actual payment varies by GPCI locality.

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU vs. total RVU

The work RVU (6.29) is the surgeon's own effort — the figure physician pay and productivity targets are built on. The total RVU (16.48) adds practice overhead and malpractice, and is what drives the Medicare payment below.

Work RVU	6.29
Practice expense RVU	8.87
Malpractice RVU	1.32
Total RVU	16.48
Medicare national rate	$550.45
Global period	90 days

Payment by site of service

Medicare pays different rates by setting. HOPD typically pays substantially more than ASC for the same procedure.

Source · CMS OPPS Addendum B·ASC HCPCS payment rates·2026

Setting	Medicare rate (national)
Office (PFS non-facility) Procedure performed in physician's office	$550.45
HOPD (APC 5111) Hospital outpatient department	$252.01
ASC (PI A2) Ambulatory surgical center (freestanding)	$135.54

Common denial reasons

The recurring reasons claims for CPT 27501 get rejected.

Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓

ICD-10 diagnosis lacks required specificity — missing laterality or encounter type (initial/subsequent/sequela)
Casting or splinting code billed separately on the same date; NCCI bundles these into 27501 when the treating physician assumes follow-up care
Claim submitted with manipulation code (e.g., 27502) but operative note documents no manipulation was performed, or vice versa
Post-op visit during the 90-day global billed without modifier 24, triggering automatic denial as included in global
Fracture pattern documented in the op/clinical note does not match the supracondylar/transcondylar anatomic level required by 27501

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 4 cited references ↓

01Can I bill a casting code on the same date as 27501 if I apply a cast at the same visit?

No. When the treating physician assumes follow-up care, NCCI bundles casting, splinting, and strapping codes into the fracture treatment code. You cannot separately bill a casting code with 27501 in that scenario. If you only apply an initial cast and will not be providing follow-up care, you would bill an E/M plus the casting code instead of 27501.

02What is the global period for 27501 and what does it include?

27501 carries a 90-day global period. It includes the day-before service, the treatment visit, and all routine post-fracture management through day 90 — dressing changes, follow-up imaging reviews, and cast checks. Unrelated visits need modifier 24 (E/M) or modifier 79 (procedure).

03If the patient later requires surgical fixation within the global period, how do I bill that?

Bill the operative procedure with modifier 58 to indicate a staged or related procedure during the global period. Modifier 58 reopens a new global period for the surgical code.

04When should I use 27501 versus 27502?

Use 27501 when the supracondylar or transcondylar fracture requires no manipulation to achieve acceptable position. Use 27502 for femoral shaft fractures treated with manipulation. If you manipulate a supracondylar/transcondylar fracture, the correct code is 27503, not 27501.

05How should laterality be reported for 27501?

Append modifier LT or RT to identify the treated side. For a hospital outpatient or ASC setting with a bilateral injury, bill two lines — one with LT and one with RT — rather than using modifier 50 on a single line, per CMS ASC billing requirements.

06Does 27501 require a specific ICD-10 code family?

Yes. Map to ICD-10-CM category S72.4 (supracondylar fracture of femur) with full specificity: fracture type, laterality, and the correct 7th character for encounter (A for initial, D for subsequent, S for sequela). Missing any of these elements is a leading cause of payer rejection for this code.

Sources & references

Editorial content was developed using the following public sources. Last verified May 8, 2026.

Mira Scribe

Mira's AI scribe captures the fracture location (supracondylar vs. transcondylar vs. intercondylar extension), explicit confirmation that no manipulation was performed, laterality, immobilization type applied, and neurovascular exam findings — all from dictation. That prevents the two most common denials: a mismatched manipulation code and an ICD-10 specificity rejection.

See how Mira captures CPT 27501 documentation