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    OpenPayerBilling CodesFracture and/or Dislocation Procedures on the Pelvis and Hip JointCPT cpt-27235-percutaneous-fixation-femoral-neck-fracture
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    CPT 27235: Percutaneous Fixation of Femoral Neck Fracture

    Medicare pays $851 on average nationally for this procedure.

    CPT code 27235 describes percutaneous fixation of a femoral neck fracture using screws and pins placed through the skin; this is an orthopedic surgical procedure performed for upper femur fractures and is typically provided as a same-day or inpatient surgical service in an operative suite or procedure room depending on patient condition and clinical setting.

    For related coverage guidance, see recent payer policy updates: Hip Arthroplasty (partial and total hip replacement), Shoulder Arthroplasty (Total, Partial, Reverse, Revision and Resurfacing), Artificial Lumbar Intervertebral Disc (Lumbar Total Disc Arthroplasty).

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    Table of contents

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    Clinical & Coding Specifications

    Clinical Context

    A 78-year-old woman slips on ice and presents to the emergency department with acute right hip pain and inability to bear weight. Imaging confirms a displaced femoral neck fracture. Orthopedic trauma evaluates the patient, obtains preoperative labs, cardiac risk assessment, and informed consent. The patient is scheduled for percutaneous fixation using multiple cannulated screws under fluoroscopic guidance. The procedure is performed in an operating room or procedure suite with moderate sedation or general anesthesia. Postoperative workflow includes recovery room monitoring, weight-bearing instructions (often partial or toe-touch depending on fracture stability), pain control, physical therapy initiation, and discharge planning with thromboprophylaxis and fall-risk mitigation.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    27096Closed treatment of posterior acetabular fracture, with or without manipulation; without external fixationNot directly for femoral neck but may be performed for concomitant pelvic fractures or stabilization in polytrauma
    20680Removal of implant; deep (e.g., buried wire, pin, screw, metal band, nail, rod or plate)Performed when hardware from prior percutaneous screw fixation requires removal due to infection, pain, or hardware failure
    20690Application of external fixation device (unilateral or bilateral)May be used as temporary stabilization prior to definitive internal fixation in unstable patients
    27030Open treatment of femoral neck fracture, includes internal fixation or prosthetic replacementRepresents alternative or more extensive approach when open reduction or hemi/total arthroplasty is required
    73030Radiologic examination, hip, unilateral, complete, minimum two viewsPreoperative and postoperative imaging to document fracture alignment and fixation
    76000Fluoroscopic guidance or C-arm imagingIntraoperative imaging guidance is required for percutaneous placement of screws (note: billable imaging codes vary by payer)

    Related Modifiers

    13 rows

    ModifierDescriptionWhen to Use
    50Modifier –50 (Bilateral Procedure) is appended to a CPT code when an identical procedure is performed on paired anatomical structures during the same operative session. The AMA states to add…- Use modifier -50 when the same CPT surgical, diagnostic, or radiology procedure is performed on paired anatomical structures (both sides of the body) during the same operative/session by the same…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    63Modifier‑63 is appended to surgical CPT codes (20000–69990) when a procedure is performed on a neonate or infant weighing ≤ 4 kg (about 8.8 lbs). The AMA/AAPC definition specifies this use and notes…- Use modifier -63 only for surgical procedures in the CPT 20000–69990 series performed on a neonate or infant who weighs ≤ 4 kg at the time of the procedure; it indicates increased complexity due to…
    76Modifier -76, Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional, is appended when the same provider performs an identical, medically necessary procedure or…- Use modifier -76 when the same physician or other qualified health care professional performs an identical procedure or service a second (or subsequent) time on the same date of service and the…
    77Modifier 77 indicates that a previously performed procedure or service was legitimately repeated by a different physician or other qualified health care professional. The AMA’s CPT definition…- Use modifier 77 when a basic procedure or service already performed is repeated by a different physician or other qualified health care professional (for example, a second provider independently…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
    79Modifier 79 indicates a surgical procedure performed during the postoperative global period of a prior surgery that is unrelated to the original procedure. Per AMA/CPT and CMS guidance, it is…- Use modifier 79 when the same physician (or same‑specialty physician in the same group) performs a surgical procedure during the postoperative global period of a prior surgery and the new procedure…
    80CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…
    81Modifier -81 indicates a physician served as a minimal assistant surgeon for part—not all—of an operative procedure. Use when a physician’s assisting role is limited and does not represent full…- Use CPT modifier -81 when a physician acts as a minimum assistant surgeon who assists during only part (a limited portion) of an operative procedure; append -81 to the primary surgical CPT code to…
    82Modifier 82 is appended to a surgical CPT code to indicate that an attending physician acted as an assistant because a qualified resident surgeon was unavailable. In teaching hospitals it documents…- When to use: Append modifier 82 in teaching-hospital settings to indicate a physician served as an assistant surgeon because a qualified resident surgeon was unavailable (includes situations where…

    Showing 1–10 of 13

    Related Provider Taxonomies

    8 rows

    Taxonomy CodeSpecialtyNotes
    207X00000XOrthopaedic Surgery PhysicianAn orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated…
    2080P0207XPediatric Hematology & Oncology PhysicianA pediatrician trained in the combination of pediatrics, hematology and oncology to recognize and manage pediatric blood disorders and cancerous disea…
    363L00000XNurse Practitioner(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision mak…
    2255A2300XAthletic TrainerAthletic trainers are allied health care professionals who work in consultation with or under the direction of physicians, and specialize in the preve…
    2278E0002XEmergency Care Certified Respiratory TherapistThe immediate availability of diagnostic and therapeutic cardiopulmonary services in the assessment and management of trauma victims, patients requiri…
    163WC0200XCritical Care Medicine Registered NurseNursing Service Providers · Registered Nurse
    2082S0105XSurgery of the Hand (Plastic Surgery) PhysicianA plastic surgeon with additional training in the investigation, preservation, and restoration by medical, surgical and rehabilitative means of all st…
    261QM1102XMilitary Outpatient Operational (Transportable) Component Clinic/Center"Non-fixed" facilities or distinct parts of a "non-fixed" facility, providing outpatient medical and dental services, primarily intended for DoD activ…

    Related ICD-10-CM Codes

    28 rows

    ICD-10-CM CodeDescription
    M80.051AAge-related osteoporosis with current pathological fracture, right femur, initial encounter for fracture
    M80.052AAge-related osteoporosis with current pathological fracture, left femur, initial encounter for fracture
    M84.451APathological fracture, right femur, initial encounter for fracture
    M84.451DPathological fracture, right femur, subsequent encounter for fracture with routine healing
    M84.452APathological fracture, left femur, initial encounter for fracture
    M84.452DPathological fracture, left femur, subsequent encounter for fracture with routine healing
    M84.459APathological fracture, hip, unspecified, initial encounter for fracture
    M84.459DPathological fracture, hip, unspecified, subsequent encounter for fracture with routine healing
    M84.561APathological fracture in neoplastic disease, right tibia, initial encounter for fracture
    M84.562APathological fracture in neoplastic disease, left tibia, initial encounter for fracture

    Showing 1–10 of 28

    Related Payer Policy Updates

    Specialty: Orthopedics/Musculoskeletal1 / 2

    7 rows

    PolicyPayerEffective Date
    Hip Arthroplasty (partial and total hip replacement)univerahealthcare2026-10-15
    Shoulder Arthroplasty (Total, Partial, Reverse, Revision and Resurfacing)univerahealthcare2026-10-15
    Artificial Lumbar Intervertebral Disc (Lumbar Total Disc Arthroplasty)univerahealthcare2026-10-15
    Metal-on-Metal Total Hip Resurfacinguniverahealthcare2026-10-15
    Lumbar Fusion (arthrodesis) with decompressionuniverahealthcare2026-10-15
    Osteochondral Grafting of the Kneeuniverahealthcare2026-10-15
    Sacroiliac Joint Fusion or Stabilizationuniverahealthcare2026-10-15

    Related Codes

    CPT-27197-POSTERIOR-PELVIC-FRACTURE-TREATMENT-NO-MANIPULATION

    CPT 27197: Treatment of Posterior Pelvic Ring Separation Without Manipulation

    CPT-27198-PELVIC-RING-MANIPULATION-UNDER-ANESTHESIA

    CPT 27198: Manipulation of Posterior Pelvic Ring Fracture

    CPT-27200-CLOSED-TREATMENT-COCCYX-FRACTURE

    CPT 27200: Closed Treatment of Coccyx (Tailbone) Fracture

    CPT-27202-OPEN-TREATMENT-COCCYX-FRACTURE-WITH-FIXATION

    CPT 27202: Open Treatment of Coccyx Fracture

    CPT-27215-ILIAC-SPINE-TUBEROSITY-AVULSION-ILIAC-WING-FIXATION

    CPT 27215: Open Treatment of Iliac Spine/Tuberosity Avulsion or Iliac Wing Fracture

    CPT-27216-PELVIC-EXTERNAL-FIXATION-FOR-PELVIC-RING-INJURY

    CPT 27216: Unilateral Pelvic External Fixation

    CPT-27217-OPEN-TREATMENT-ANTERIOR-PELVIC-RING-FRACTURE-FIXATION

    CPT 27217: Open Treatment of Anterior Pelvic Ring Fracture

    CPT-27218-OPEN-TREATMENT-POSTERIOR-PELVIC-RING-FRACTURE-FIXATION

    CPT 27218: Open Treatment of Posterior Pelvic Fracture

    CPT-27220-CLOSED-TREATMENT-ACETABULAR-FRACTURE

    CPT 27220: Closed Treatment of Acetabular (Hip Socket) Fracture

    CPT-27222-CLOSED-TREATMENT-ACETABULAR-FRACTURE

    CPT 27222: Closed Treatment of Acetabular (Hip Socket) Fracture

    Showing 1–10 of 35

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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