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See a sample rate comparisonCPT 27506 Fee Schedule
Medicare rates as of October 2026
CPT 27506 is classified under Surgery, in the Surgical Procedures on the Musculoskeletal System subgroup.
Treatment Of Thigh Fracture, Open Treatment Of Femoral Shaft Fracture With Or Without External Fixation With Insertion Of Intramedullary Implant With Or Without Cerclage And Or Locking Screws
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 21Inpatient Hospital 22On Campus Outpatient Hospital |
| Common Modifiers | RTRight side of body LTLeft side of body |
| Hospital Outpatient Group (APC) | APC 5114 - Level 4 Musculoskeletal Procedures |
| Surgery Center Payment (ASC) | J8 - Device-intensive procedure, paid at an adjusted rate |
| Add-on Codes | 20702 |
| Common Revenue Codes | 03600960Sign up to view all 4 |
| Medicare Fee Schedule | $1,223.14 national non-facility rate (2026)View Medicare rates for 27506 |
| Medicaid Fee Schedule | $972.24 median of the 8 states in the free previewView Medicaid rates for 27506 |
National average reimbursement for CPT 27506 by major payers:
$1,737.94
BCBS / Anthem
$1,801.10
UnitedHealthcare
$1,926.81
Aetna
$2,178.85
Cigna
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 27506.
CPT 27506
5 of 25 sample ratesHigher to lower in this preview
Endoscopy Center Of Inland Empire Inc
$6,506.00Published rateNovant Health Brunswick Endoscopy Center, LLC, Novant Health Brunswick Endoscopy
Novant Health Brunswick Endoscopy Center LLC
$4,579.00Published ratePain Care Surgery, PC
Pain Care Surgery PC
$2,617.00Published rateSmart Pain Surgery Center At Owings Mills, LLC, Clearway Surgery Center Of Owings Mills
Smart Pain Surgery Center At Owings Mills LLC
$1,919.00Published rateSkin & Mohs Surgery Center, LLC
Skin Mohs Surgery Center LLC
$843.00Published rate
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See a sample payer proposalCPT 27506 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The table lists codes related to 27506. Select one to see its fee schedule.
| Code | Description |
|---|---|
| 27500-CPT | Closed Treatment Of Femoral Sh, Closed Treatment Of Femoral Shaft Fracture Withoutmanipulation Closed Treatment Of Femoral Shaft Fracture Without |
| 27501-CPT | Closed Treatment Of Supracondy, Closed Treatment Of Supracondylar Or Transcondylarfemoralfracture With Or Without Intercondylar Ext Ension Without Manipulation |
| 27503-CPT | Treatment Of Thigh Fracture, Closed Treatment Of Supracondylar Or Transcondylar Femoral Fracture With Or Without Intercondylar Extension With Manipulation With Or Without Skin Or Skeletal Traction |
| 27506-CPT | Treatment Of Thigh Fracture, Open Treatment Of Femoral Shaft Fracture With Or Without External Fixation With Insertion Of Intramedullary Implant With Or Without Cerclage And Or Locking Screws |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 27506. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 27506 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 is CPT 27506?
CPT 27506 reports open treatment of a femoral shaft fracture with an intramedullary implant (rod or nail), with or without external fixation, cerclage or locking screws. Fixation with a plate and screws uses 27507.
What is the global period for CPT 27506?
CPT 27506 has a 90-day global period. It is almost always performed in a hospital, so the facility rate is the relevant Medicare benchmark.
Why do payer rates for CPT 27506 vary?
Medicare pays the surgeon for CPT 27506 under the Physician Fee Schedule, adjusted for the local cost of practice, and the hospital or surgery center bills a separate facility fee. Commercial payers negotiate their own professional rates, often as a percentage of Medicare, and those contracts vary widely by payer, plan and market.
Where can I compare CPT 27506 rates by payer?
This page lists the rates commercial payers have published for CPT 27506 in their Transparency in Coverage files, so you can compare payers and see where a contract falls. For government benchmarks, PayerPrice also has the Medicare fee schedule lookup and Medicaid fee schedules by state.
What APC is CPT 27506 assigned to?
Medicare's hospital outpatient payment system (OPPS) assigns CPT 27506 to APC 5114 (Level 4 Musculoskeletal Procedures). An APC groups outpatient services that Medicare pays at the same base rate.
How does Medicare pay for CPT 27506 in an ambulatory surgery center?
CMS lists CPT 27506 with ASC payment indicator J8: Device-intensive procedure, paid at an adjusted rate.
Which add-on codes are billed with CPT 27506?
CMS add-on code edits list CPT 27506 as a primary code for these add-on codes: 20702.
Which revenue codes are billed with CPT 27506?
Hospital price transparency files list CPT 27506 under these revenue codes: 0360, 0960, 0975 and 0989. A revenue code names the hospital department or charge category for the line; it does not change what the service is.