Closed treatment of a distal femoral fracture at the medial or lateral condyle, performed with manipulation to restore alignment.

Verified May 8, 2026 · 4 sources ↓

Medicare: $672.69
Work RVU: 9.56
Global, days: 90
Region: Knee

Drawn from AAPCAbosGenhealthCMS

Documentation requirements

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

Source · Editorial brief grounded in 4 cited references ↓

Fracture location specified as distal femur, medial or lateral condyle — not just 'distal femur'
Confirmation that treatment was closed (no incision) with manual manipulation performed
Pre- and post-reduction imaging (X-ray or CT) documenting fracture pattern and alignment achieved
Type of immobilization applied (splint, cast, brace) and extremity side (LT/RT)
Anesthesia type used during manipulation, if applicable
Neurovascular status of the limb documented pre- and post-procedure

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 52 Reduced services 58 Staged or related 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 4 cited references ↓

CPT 27510 describes closed reduction — no incision — of a fracture at the distal end of the femur involving either the medial or lateral condyle. The surgeon manually manipulates the fracture fragments to restore condylar alignment and knee joint congruity, then immobilizes the extremity. No internal fixation is placed; if percutaneous fixation is added, step up to 27509. If the fracture is opened and internally fixed, use 27514 instead.

The 90-day global period starts on the date of the procedure and covers all routine follow-up, casting adjustments, and office visits through day 90. Any visit for an unrelated condition in that window requires modifier 24. A staged or planned return to the OR for a related procedure (e.g., delayed ORIF once swelling resolves) requires modifier 58. An unplanned return to the OR for a related complication uses modifier 78.

Code selection within the distal femur fracture family hinges on two variables: whether the condyle is medial or lateral (both are captured by 27510), and whether the treatment is closed with manipulation (27510), percutaneous fixation (27509), or open with internal fixation (27514). Supracondylar and transcondylar patterns without intercondylar extension go to 27511/27513, not 27510. Getting the anatomic descriptor right in the operative note is the single most effective way to defend the code selection on audit.

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 (9.56) is the surgeon's own effort — the figure physician pay and productivity targets are built on. The total RVU (20.14) adds practice overhead and malpractice, and is what drives the Medicare payment below.

Work RVU	9.56
Practice expense RVU	8.45
Malpractice RVU	2.13
Total RVU	20.14
Medicare national rate	$672.69
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	$672.69
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 27510 get rejected.

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

Wrong code selected — 27511 or 27514 billed when closed reduction without fixation was performed
Operative note documents internal fixation, contradicting the closed treatment code
ICD-10 fracture diagnosis code does not specify condyle (medial or lateral) or laterality, causing CPT-ICD mismatch
Modifier LT or RT missing when payer requires laterality on extremity fracture codes
Routine post-op visit billed separately without modifier 24 during the 90-day global period

Frequently asked questions

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

01What is the difference between 27510 and 27509?

27510 is closed reduction with manipulation only — no fixation hardware. 27509 adds percutaneous skeletal fixation (e.g., pins placed through intact skin). If you placed any hardware percutaneously, 27509 is correct, not 27510.

02Can I bill 27510 if the fracture involves both condyles?

27510 covers medial or lateral condyle fractures. A bicondylar or intercondylar pattern treated closed with manipulation still maps here if no fixation is added, but document the full fracture pattern — payers and auditors will check the imaging report against the ICD-10 code for consistency.

03Does the 90-day global include casting and cast changes?

Yes. Routine cast application, cast changes, and removal are bundled into the 90-day global for 27510. Billing those separately will trigger a bundling edit. If the patient presents with a new, unrelated problem during that window, use modifier 24 on the E/M.

04What modifier do I use if the patient needs ORIF six weeks after closed reduction?

Use modifier 58 — staged or related procedure during the global period. This signals a planned progression of care, not a complication. Modifier 78 is for an unplanned return to the OR for a complication of the original procedure.

05Is modifier 50 appropriate for bilateral distal femur condyle fractures?

Bilateral distal femur condyle fractures are rare but do occur in high-energy trauma. If both sides are treated in the same session, modifier 50 applies. Document each side independently in the operative note and confirm payer acceptance — some commercial payers require LT and RT on separate line items instead of modifier 50.

06What ICD-10 codes pair with 27510?

Use S72.4xx codes for distal femur fractures, selecting the most specific descriptor for medial condyle (S72.41x), lateral condyle (S72.42x), or unspecified condyle (S72.40x), with the appropriate 7th character for encounter type (A = initial, D = subsequent, G = delayed healing, etc.). Initial treatment uses the 'A' character; post-op follow-up within the global uses 'D'.

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 (distal femur, medial vs. lateral condyle), the closed manipulation technique, pre- and post-reduction alignment findings from imaging, immobilization type, and operative laterality — all in the dictation. That specificity prevents the most common audit flag: an operative note that says 'distal femur fracture reduced' without naming the condyle, which invites a coding downgrade or ICD-CPT mismatch denial.

See how Mira captures CPT 27510 documentation