Closed reduction of a supracondylar or transcondylar femoral fracture with manipulation, with or without intercondylar extension, with or without skin or skeletal traction.

Verified May 8, 2026 · 6 sources ↓

Medicare: $750.52
Total RVUs: 22.47
Global, days: 90
Region: Knee

Drawn from CMSAAPCEmednyMedicaidFindacode

Documentation requirements

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

Source · Editorial brief grounded in 6 cited references ↓

Fracture pattern: confirm supracondylar or transcondylar location, with or without intercondylar extension — imaging report and clinical correlation required
Manipulation documented explicitly: note must state that closed reduction with manual manipulation was performed, not simply that the fracture was immobilized
Traction type and method: specify skin traction vs. skeletal traction if applied, including pin site, weight, and duration
Post-reduction alignment: document fluoroscopic or radiographic confirmation of fracture position achieved after manipulation
Neurovascular status: pre- and post-reduction neurovascular exam of the affected extremity must be recorded
Fracture classification or description: AO/OTA or descriptive characterization of displacement, angulation, and comminution supports medical necessity

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 52 Reduced services 57 Decision for surgery 58 Staged or related 76 Repeat, same physician 77 Repeat, another physician 78 Unplanned return — related 79 Unrelated during global 80 Assistant surgeon LT Left side RT Right side

What this code covers

Source · Editorial summary grounded in 6 cited references ↓

CPT 27503 covers closed treatment of a supracondylar or transcondylar femoral fracture requiring manipulation to restore alignment, with or without intercondylar extension and with or without skin or skeletal traction. No surgical incision is made — the surgeon manipulates the fracture externally, then applies traction or immobilization as needed to maintain reduction. This distinguishes 27503 from 27501, which covers the same fracture pattern without manipulation.

The 90-day global period means the reduction, same-day imaging review, and all routine post-fracture management through day 90 are bundled into one payment. Separate E/M billing within that window requires modifier 24 (unrelated) or, if the decision to perform the procedure was made the same day, modifier 57 on the E/M. If a subsequent related procedure is required — such as conversion to open fixation — use modifier 78. An unrelated procedure in the global window gets modifier 79.

Fluoroscopic guidance used to confirm reduction is not separately reportable when it is part of confirming the closed reduction itself; check NCCI PTP edits before appending any imaging code. When traction is applied, document the type (skin vs. skeletal) and duration in the operative note, as payers audit traction specificity to confirm the higher-complexity code over 27501.

RVU & reimbursement

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

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU	10.99
Practice expense RVU	9.12
Malpractice RVU	2.36
Total RVU	22.47
Medicare national rate	$750.52
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	$750.52
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 27503 get rejected.

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

Upcoding flags when documentation does not distinguish manipulation from simple immobilization — payers downcode to 27501 if no reduction attempt is described
Missing traction documentation when traction is implied by the code selection but the note is silent on type, application, or necessity
Unbundling of fluoroscopy or imaging guidance billed separately when NCCI edits bundle it into the procedure
E/M services billed same-day without modifier 24 or 57, triggering global period bundling denials
ICD-10 diagnosis mismatch — fracture codes lacking laterality, displacement status, or episode of care suffix (A for initial, D for subsequent) cause claim rejection

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 6 cited references ↓

01What separates 27503 from 27501?

27501 is closed treatment of the same supracondylar or transcondylar fracture pattern without manipulation. If the surgeon performs active closed reduction — manually correcting alignment — that's 27503. If the fracture is immobilized in place without a reduction attempt, use 27501.

02Can I bill a separate E/M on the same day as 27503?

Only with a modifier. If the E/M was the decision-making visit that led to the reduction, append modifier 57 to the E/M. For a truly separate, unrelated E/M within the 90-day global, use modifier 24. A same-day E/M related to the fracture management is bundled and not separately billable.

03Is fluoroscopy separately billable with 27503?

Generally no. Fluoroscopic guidance used to confirm closed reduction is typically bundled via NCCI PTP edits. Review current NCCI edits before billing a fluoroscopy code alongside 27503 — billing it without an applicable modifier is a common audit flag.

04When does the 90-day global period start?

The global period begins the day of the procedure (day 0). Routine follow-up visits, dressing changes, and fracture checks through day 90 are included in the global payment. Bill modifier 79 for any unrelated surgical procedure performed in that window.

05What ICD-10 code structure is required to support 27503?

Use a distal femur fracture code from the S72 category. The code must specify laterality (right vs. left), displacement status (displaced vs. nondisplaced), and the correct 7th character episode-of-care suffix — 'A' for the initial active treatment encounter. Missing any of these elements triggers claim rejection at the clearinghouse or payer level.

06Does 27503 cover both skin and skeletal traction?

Yes. The code includes both skin and skeletal traction as optional components of the closed treatment. If traction is applied, document the method specifically in the operative note; vague references to 'traction applied' without type or technique detail weaken medical necessity support.

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 pattern (supracondylar vs. transcondylar, with or without intercondylar extension), the fact that manual manipulation was performed, traction type if applied, and the post-reduction radiographic or fluoroscopic result — all from dictation. That prevents the most common downcode trigger: a note that describes positioning or splinting but never explicitly documents the reduction maneuver.

See how Mira captures CPT 27503 documentation