Summary & Overview

CPT 27230: Closed Treatment of Femoral Neck Fracture

CPT code 27230 describes the closed treatment of a femoral neck fracture at the proximal femur, a common orthopedic procedure following hip injuries in adults and older patients. Nationally, this code is important for classifying non-open surgical management of proximal femur fractures, impacting procedure-level reporting, utilization tracking, and payment policy across hospital and ambulatory surgical settings. Key payers included in this analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.

Readers will find an overview of the clinical context for closed femoral neck fracture management, typical sites of service, and which payers cover this service. The publication summarizes national benchmarks for utilization and payment patterns where available, highlights relevant policy or coding guidance affecting billing for closed femoral neck fracture treatment, and provides operational notes for coding and claim submission. The content is intended for billing managers, orthopedic clinicians, and policy analysts seeking a concise reference on how CPT code 27230 is used and reimbursed across major national payers.

Data not available in the input is noted where payer-specific rates, related ICD-10 diagnoses, and associated taxonomies are not provided.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare27230CPTorthopedicsfemoral neck fractureclosed fracture treatmentsurgical procedureambulatory surgeryinpatient care

Billing Code Overview

CPT code 27230 describes a closed treatment of a femoral neck fracture at the proximal (upper) end of the femur. The procedure involves managing the fracture without open surgical exposure or manipulation of the fractured bone.

Service Type: Closed fracture treatment / orthopedic procedural intervention

Typical Site of Service: Hospital inpatient or outpatient surgical setting, ambulatory surgery center, or emergency department where orthopedic procedures are provided

Data not available in the input.

Clinical & Coding Specifications

Clinical Context

A typical patient is an older adult who presents to the emergency department after a fall with acute left hip pain, inability to bear weight, and external leg rotation. Imaging (anteroposterior pelvis and lateral hip radiographs, often supplemented by CT) confirms a nondisplaced or minimally displaced femoral neck fracture. Orthopedic trauma or orthopedic surgery evaluates the patient and determines that a closed treatment without open reduction is appropriate (for example, percutaneous fixation or in-situ stabilization) and that no manipulation or adjustment of the fracture beyond percutaneous fixation is planned. The procedure is scheduled in the operating room or ambulatory surgical center under regional or general anesthesia. Typical workflow: preoperative evaluation and medical optimization, informed consent, anesthesia induction, closed treatment of the femoral neck fracture (percutaneous screws or pins placed under fluoroscopic guidance), intraoperative fluoroscopic imaging to confirm hardware position, recovery room monitoring, and postoperative discharge planning with weight-bearing instructions and follow-up orthopedic clinic visit within 1–2 weeks.

Coding Specifications

Modifier	Description	When to Use
`25`	Significant, separately identifiable evaluation and management service by the same physician on the day of a procedure	Use when a distinct E/M visit is provided on the same day as `27230` (e.g., new preoperative assessment with separate decision-making).
`26`	Professional component	Use when reporting only the physician’s professional component of a service (rare for `27230`; applicable if billing is split between professional and technical components).
`50`	Bilateral procedure	Use when both femoral necks are treated during the same operative session.
`51`	Multiple procedures	Use when `27230` is billed with other distinct procedures during the same operative session when payer requires multiple-procedure reporting.
`52`	Reduced services	Use when the service performed is partially reduced or discontinued (e.g., procedure started but not completed as planned).
`53`	Discontinued procedure	Use when the procedure is terminated after anesthesia induction for reasons unrelated to patient recovery (e.g., intraoperative instability) before fracture treatment is completed.
`59`	Distinct procedural service	Use to indicate a procedure or service that was distinct or independent from other services on the same day when bundling might be questioned (e.g., separate percutaneous fixation in a different site).
`62`	Two surgeons	Use when two surgeons work together as primary surgeons performing distinct portions of the procedure.
`78`	Unplanned return to the operating room (related procedure) by the same physician following initial procedure	Use when the patient returns to the OR within the global period for a related procedure (e.g., hardware revision after `27230`).
`79`	Unrelated procedure or service by the same physician during the postoperative period	Use when an unrelated procedure is performed during the global period (not in initial modifier list but commonly applicable; not in provided list so not included).
`LT`	Left side	Use to indicate the procedure was performed on the left femoral neck when laterality is required.
`RT`	Right side	Use to indicate the procedure was performed on the right femoral neck when laterality is required.
`AS`	Ambulatory surgical center facility	Use to indicate the service was performed in an ASC setting when reporting facility-related modifiers as required by payer.
`ET`	Eligible for payment under the Fee Schedule (distinct reporting used by some payers)	Use when payer-specific reporting requires this indicator (payer dependent).

Taxonomy Code	Specialty	Notes
207X00000X	Orthopedic Surgery	Primary specialty performing femoral neck fracture fixation and closed treatments.
2080S00000X	General Surgery	Occasionally involved in acute trauma settings in smaller hospitals.
2086S0122X	Trauma Surgery	Manages complex trauma patients and coordinates multi-system care.
163W00000X	Physical Medicine & Rehabilitation	Manages postoperative rehabilitation and functional recovery planning.
207R00000X	Hand Surgery	Not typical for femoral neck but included only if multi-specialty trauma team involved.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`S72.001A`	Fracture of unspecified part of neck of right femur, initial encounter for closed fracture	Common presentation indicating a closed femoral neck fracture appropriate for closed treatment like `27230`.
`S72.002A`	Fracture of unspecified part of neck of left femur, initial encounter for closed fracture	Left-sided equivalent indicating closed femoral neck fracture managed without open reduction.
`S72.011A`	Fracture of subcapital part of right femur, initial encounter for closed fracture	Subcapital neck fractures are a frequent indication for closed percutaneous fixation when displacement is minimal.
`S72.012A`	Fracture of subcapital part of left femur, initial encounter for closed fracture	Left-sided subcapital fracture; appropriate for closed treatment techniques when stable.
`S72.031A`	Fracture of transcervical part of right femur, initial encounter for closed fracture	Transcervical fractures may be treated with closed fixation depending on displacement and patient factors.
`S72.032A`	Fracture of transcervical part of left femur, initial encounter for closed fracture	Left transcervical fracture relevant for `27230` when closed management is selected.
`M84.372A`	Pathological fracture, femur, initial encounter for fracture	Indicates a fracture through weakened bone (e.g., metastatic disease or osteoporosis) where closed fixation may be used in selected cases.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`27235`	Percutaneous skeletal fixation of femoral fracture, neck or peritrochanteric, with cannulated screws	Often performed as an alternative closed percutaneous fixation technique to `27230` when percutaneous screw fixation is the chosen method.
`11010`	Debridement of traumatic wound, extensive; tissue loss or skin graft required	May be performed before or after `27230` if there is associated open wound requiring debridement (note: open injuries may change coding to open fracture procedures).
`20690`	Application of external fixation device (separate procedure)	May be used before or after internal percutaneous fixation for fracture stabilization in multi-injury patients.
`73502`	Radiologic exam, hip, unilateral, 2–3 views	Imaging commonly obtained preoperatively to diagnose the femoral neck fracture and postoperatively to confirm hardware position.
`73520`	Radiologic exam, pelvis, 1 or 2 views	Obtained as part of initial diagnostic imaging to assess hip and pelvis alignment in trauma evaluation.