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See a sample rate comparisonCPT 27238 Fee Schedule
Medicare rates as of October 2026
CPT 27238 is classified under Surgery, in the Surgical Procedures on the Musculoskeletal System subgroup.
Closed Treatment Of Intertroch, Closed Treatment Of Intertrochanteric Pertrochanteric Orsubtrochanteric Femoral Fracture Without Manipulation Closed Treatment Of Intertrochanteric Pertrochanteric Or
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 21Inpatient Hospital 23Emergency Room 11Office |
| Common Modifiers | LTLeft side of body RTRight side of body |
| Hospital Outpatient Group (APC) | APC 5112 - Level 2 Musculoskeletal Procedures |
| Surgery Center Payment (ASC) | A2 - Paid separately, from the OPPS relative weight |
| Common Revenue Codes | 04500360Sign up to view all 7 |
| Medicare Fee Schedule | $457.59 national non-facility rate (2026)View Medicare rates for 27238 |
| Medicaid Fee Schedule | $366.60 median of the 8 states in the free previewView Medicaid rates for 27238 |
National average reimbursement for CPT 27238 by major payers:
$664.51
BCBS / Anthem
$617.94
UnitedHealthcare
$647.85
Aetna
$765.34
Cigna
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 27238.
CPT 27238
5 of 25 sample ratesHigher to lower in this preview
Memorial Ambulatory Surgery Center, LLC
Virtua-Memorial Hospital Burlington County Inc
$3,624.00Published rateLawrence Surgery Center LLC
Lawrence Surgery Center, LLC
$620.00Published rateNeospine Puyallup Spine Center, LLC, Microsurgical Spine Center
Neospine Puyallup Spine Center LLC
$330.00Published rateThe Hutchinson Ophthalmology Asc LLC, Surgery Center Of South Central Kansas
The Hutchinson Ophthalmology Asc LLC
$163.00Published rateEye Surgicenter LLC
$42.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 27238 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The table lists codes related to 27238. Select one to see its fee schedule.
| Code | Description |
|---|---|
| 27235-CPT | Percutaneous Skeletal Fixation, Percutaneous Skeletal Fixation Of Femoral Fracture Proximalend Neck Undisplaced Mildly Displaced Or Impacted Fracture |
| 27236-CPT | Repair And Secure A Broken Hip, Surgery To Repair A Broken Hip. Pins Wires Or Rods May Hold The Bone Together. The End Of The Bone May Be Replaced With An Artificial Part. |
| 27238-CPT | Closed Treatment Of Intertroch, Closed Treatment Of Intertrochanteric Pertrochanteric Orsubtrochanteric Femoral Fracture Without Manipulation Closed Treatment Of Intertrochanteric Pertrochanteric Or |
| 27240-CPT | Closed Treatment Of Intertroch, Closed Treatment Of Intertrochanteric Pertrochanteric Orsubtrochanteric Femoral Fracture With Manipulation With Or Without Skin Or Skeletal Traction |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 27238. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 27238 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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Frequently Asked Questions
What APC is CPT 27238 assigned to?
Medicare's hospital outpatient payment system (OPPS) assigns CPT 27238 to APC 5112 (Level 2 Musculoskeletal Procedures). An APC groups outpatient services that Medicare pays at the same base rate.
How does Medicare pay for CPT 27238 in an ambulatory surgery center?
CMS lists CPT 27238 with ASC payment indicator A2: Paid separately, from the OPPS relative weight.
Which revenue codes are billed with CPT 27238?
Hospital price transparency files list CPT 27238 under these revenue codes: including 0450, 0360, 0361, 0761 and 0960. A revenue code names the hospital department or charge category for the line; it does not change what the service is.