Closed treatment of a femoral shaft fracture with manipulation, with or without traction applied to achieve bone alignment

Verified May 8, 2026 · 5 sources ↓

Medicare: $752.52
Total RVUs: 22.53
Global, days: 90
Region: Knee

Drawn from CMSAAPCHcmarketplace

Documentation requirements

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

Source · Editorial brief grounded in 5 cited references ↓

Confirm fracture location as the femoral shaft (diaphysis), not supracondylar, subtrochanteric, or femoral neck — site specificity drives code selection
Document whether manipulation was performed and describe the technique used to achieve reduction
Specify the traction method if used: skin traction, skeletal traction (with pin/wire placement), or none — and document rationale
Record pre- and post-reduction imaging findings confirming alignment achieved
Note the immobilization method applied: spica cast, cast brace, or traction apparatus with specifics
If external fixation was placed, document system type (uniplane vs. multiplane) to support separate reporting of 20690 or 20692

Applicable modifiers

Modifiers commonly billed with this code.

Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual

22 Increased complexity 50 Bilateral procedure 51 Multiple procedures 52 Reduced services 58 Staged or related 59 Distinct service 76 Repeat, same physician 77 Repeat, another physician 78 Unplanned return — related 79 Unrelated during global LT Left side RT Right side

What this code covers

Source · Editorial summary grounded in 5 cited references ↓

CPT 27502 covers closed (non-operative) reduction of a femoral shaft fracture — the middle portion of the femur — using manual manipulation to restore alignment, with or without skin or skeletal traction. No incision is made. The treating provider physically reduces the fracture and may apply traction via weights and pulleys, pins, or strapping to maintain position while healing progresses. If traction is not required, the extremity is typically immobilized in a spica cast or cast brace.

Code 27502 is site-specific: it applies only to the shaft (diaphysis) of the femur. Supracondylar or transcondylar femoral fractures with manipulation fall under 27503. Open treatment of a femoral shaft fracture routes to 27506 or 27507. Getting this distinction wrong is the most common upcoding/downcoding flag on femur fracture claims.

The 90-day global period covers all routine post-reduction management, cast checks, and traction adjustments. If an external fixation system is required, report 20690 (uniplane) or 20692 (multiplane) separately — those are not bundled into 27502. Radiology for fracture assessment bills separately under 73551–73552. Cast application or strapping is not separately reportable when performed as part of the restorative treatment.

RVU & reimbursement

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

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU	11.08
Practice expense RVU	8.93
Malpractice RVU	2.52
Total RVU	22.53
Medicare national rate	$752.52
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	$752.52
HOPD (APC 5112) Hospital outpatient department	$1,642.82
ASC (PI A2) Ambulatory surgical center (freestanding)	$872.87

Common denial reasons

The recurring reasons claims for CPT 27502 get rejected.

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

Wrong code for fracture site — 27502 is shaft-only; supracondylar fractures with manipulation belong under 27503
Upcoding to open treatment codes (27506–27507) when no incision was made, or downcoding 27502 when the record supports it
ICD-10 diagnosis code laterality mismatch — femur fracture codes require right/left specificity (e.g., S72.301A vs. S72.302A) and encounter type suffix
Separate billing of cast application or strapping as an add-on when it is included in the restorative treatment under the global
Missing or insufficient imaging documentation to support that a fracture was present and manipulation was medically necessary

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 5 cited references ↓

01What is the difference between 27500 and 27502?

27500 is closed treatment of a femoral shaft fracture without manipulation. 27502 requires that the provider performed manipulation to reduce the fracture. If the operative note or procedure record doesn't document active reduction maneuvers, 27500 is the correct code.

02Can I bill external fixation separately with 27502?

Yes. If a uniplane external fixation system is applied, report 20690 separately. A multiplane system bills as 20692. These are not bundled into 27502 per CPT guidelines.

03Does the 90-day global include traction management?

Yes. Routine traction adjustments, cast checks, and post-reduction visits for the same fracture are all included in the 90-day global. Bill modifier 24 for unrelated E/M visits and modifier 79 for unrelated procedures performed during the global period.

04How do I code a femoral shaft fracture with open treatment instead?

If the fracture requires open treatment, 27502 is wrong. Use 27506 for open treatment with intramedullary implant or 27507 for open treatment with plate/screws. Billing 27502 when an open procedure was performed misrepresents the service.

05What ICD-10 codes pair with 27502?

Femoral shaft fracture codes from category S72.3 (e.g., S72.301A for unspecified right femoral shaft fracture, initial encounter) are the primary pairings. Always include laterality and the correct 7th character for encounter type — 'A' for initial, 'D' for subsequent, 'G' for delayed healing, 'K' for nonunion.

06Is radiology billable separately with 27502?

Yes. Radiological supervision and interpretation for fracture assessment bills separately under 73551 or 73552. Imaging is not bundled into the global surgical package for fracture care.

Sources & references

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

Mira AI Scribe

Mira's AI scribe captures the fracture site (femoral shaft vs. supracondylar vs. neck), the manipulation technique, traction type applied or rationale for none, pre- and post-reduction alignment findings, and the immobilization method used. That specificity prevents downcoding to 27500 (closed treatment without manipulation) and blocks ICD-10 laterality mismatches — the two triggers most likely to kick a femoral shaft fracture claim back on first pass.

See how Mira captures CPT 27502 documentation