Closed treatment of a distal femur fracture involving the medial or lateral condyle, performed without manipulation.

Verified May 8, 2026 · 5 sources ↓

Medicare: $581.51
Work RVU: 6.05
Global, days: 90
Region: Knee

Drawn from CMSAAPCEmednyOutsourcestrategiesFindacode

Documentation requirements

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

Source · Editorial brief grounded in 5 cited references ↓

Imaging confirming distal femur fracture with medial or lateral condyle involvement
Explicit statement that no manipulation was performed and clinical rationale for non-manipulative treatment
Laterality documented — specify medial or lateral condyle and left vs. right limb
Type of immobilization applied (cast, splint, or brace) and post-application assessment
Neurovascular status of the extremity before and after treatment
Fracture classification or descriptor (e.g., displaced vs. nondisplaced) supporting the chosen treatment approach

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 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 LT Left side RT Right side

What this code covers

Source · Editorial summary grounded in 5 cited references ↓

CPT 27508 covers closed treatment of a distal femoral fracture at the medial or lateral condyle when no manipulation is performed. The fracture is considered stable enough that reduction is not required — the goal is immobilization and protection of the fracture site, typically via casting, splinting, or bracing, to allow healing without surgical intervention or manual realignment.

Despite the absence of manipulation, this is classified as major surgery under AMA and federal coding conventions. That classification matters: a 90-day global period applies, covering all routine fracture management, cast changes, and follow-up visits through day 90. Any E/M visit on the same day as the initial fracture care decision requires modifier 57 if that visit drove the decision to treat. Unrelated procedures in the global window need modifier 79; related staged procedures need modifier 58.

Differentiate 27508 carefully from adjacent codes. Use 27510 when manipulation is performed on the same condylar fracture. Use 27509 when percutaneous skeletal fixation is added. Misapplying 27510 or 27509 to a no-manipulation scenario — or vice versa — is a common audit target. Diagnosis codes must specify laterality (medial vs. lateral condyle) and fracture type; unspecified condyle codes frequently trigger payer requests for additional documentation.

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 (6.05) is the surgeon's own effort — the figure physician pay and productivity targets are built on. The total RVU (17.41) adds practice overhead and malpractice, and is what drives the Medicare payment below.

Work RVU	6.05
Practice expense RVU	10.08
Malpractice RVU	1.28
Total RVU	17.41
Medicare national rate	$581.51
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	$581.51
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 27508 get rejected.

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

ICD-10 diagnosis code lacks specificity — unspecified condyle or missing laterality
Payer downcodes to cast/splint application code when operative note doesn't establish fracture care management
E/M billed same-day without modifier 57, triggering bundling denial under the 90-day global
27510 (with manipulation) billed instead of 27508, or vice versa, when operative note is ambiguous about whether reduction was attempted
Missing imaging documentation to support the condylar fracture diagnosis

Frequently asked questions

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

01Does 27508 have a global period, and what does it cover?

Yes — 90-day global. It includes the day of service, the day-before pre-op visit if applicable, and all routine fracture management visits, cast or splint changes, and follow-up through day 90. Bill modifier 24 for unrelated E/M visits in that window.

02When should I use 27508 vs. 27510?

27508 is for closed treatment without manipulation. Use 27510 when the treating provider performs manual reduction of the same medial or lateral condyle fracture. The operative or procedure note must explicitly state whether manipulation was performed — don't leave it to inference.

03Can I bill an E/M on the same day as 27508?

Yes, if the E/M was the visit where the decision to perform fracture care was made. Append modifier 57 to the E/M. Modifier 25 is for minor procedures with 0- or 10-day globals; 27508 carries a 90-day global, so 57 is the correct modifier for same-day decision E/Ms.

04What diagnosis codes pair with 27508?

Use ICD-10 codes from the S72.4x series for femoral condyle fractures. Specify laterality (medial vs. lateral condyle) and left vs. right. Nondisplaced condyle fractures are the typical clinical scenario for 27508 — make sure the ICD-10 code reflects displaced vs. nondisplaced status to match your documentation.

05Is 27508 appropriate when a cast is applied at the same visit?

Yes — the immobilization is part of the fracture care and is not separately billable. Do not stack a cast application code on top of 27508; it will bundle. The cast or splint is bundled into the fracture care global.

06Can 27508 be billed bilaterally?

Bilateral distal condyle fractures are rare but if they occur, append modifier 50 and document each side's fracture in the record. Most payers will reimburse at 150% of the single-procedure rate. Confirm payer-specific bilateral payment policy before billing.

07If I see this patient after another provider did the initial fracture care, how do I bill?

Use modifier 55 (postoperative management only) if you're taking over post-op care within the global period. The initial treating provider should bill modifier 54 (surgical care only). The global period days are divided between providers; coordinate billing to avoid duplicate global claims.

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 (medial or lateral condyle, left or right), the explicit absence of manipulation, the immobilization method applied, and the neurovascular exam findings — all from dictation. That prevents the two most common denials: a condyle-unspecified ICD-10 code and a payer challenge that fracture care was never documented as distinct from a cast application.

See how Mira captures CPT 27508 documentation