Summary & Overview
CPT 27238: Closed Treatment of Femoral Fracture, Stable Nondisplaced
CPT code 27238 denotes a closed treatment for femoral fractures located between, around, or below the trochanters for stable, nondisplaced injuries. This procedure represents a nonoperative management option that avoids manipulation or adjustment of the fractured bone, and it is a common entry on claims for orthopedic trauma care. Nationally, appropriate use of this code affects hospital and outpatient orthopedic billing, influences episode-level payments for hip and proximal femur fractures, and informs quality and utilization monitoring for nonoperative fracture management.
Key payers included in the analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical context for when CPT code 27238 applies, typical sites of service, and which payers commonly adjudicate claims involving this code. The publication outlines expected benchmarking categories, summarizes policy and coverage considerations relevant to nonoperative femoral fracture care, and highlights coding boundaries to distinguish closed nonmanipulative treatment from procedures that require manipulation or open reduction. Data not available in the input will be noted where applicable.
Billing Code Overview
CPT code 27238 describes a closed treatment of a femoral fracture between, around, or below the trochanters for a stable, nondisplaced fracture. The procedure does not include manipulation or adjustment of the fractured bone and is intended for fractures that can be managed without open reduction.
Service type: Closed treatment of femoral fracture (nonoperative management)
Typical site of service: Hospital inpatient or outpatient orthopedic service, emergency department, or ambulatory surgical center depending on patient stability and institutional practice
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A typical patient is an elderly adult who presents after a low-energy fall with localized thigh pain and inability to bear weight. Imaging (anteroposterior and lateral femur and hip radiographs, and often CT if needed) demonstrates a stable, nondisplaced intertrochanteric or subtrochanteric femoral fracture that does not require open reduction. The orthopedic trauma or orthopedic surgery team evaluates the patient in the emergency department or inpatient setting. After assessment of neurovascular status, medical optimization, and informed consent, the patient is taken to the operating room or procedure suite for a closed treatment procedure in which the provider treats the femoral fracture without manipulation or adjustment of the fracture fragments (no open reduction, no major fragment manipulation). Typical steps include preoperative localization with fluoroscopy, application of percutaneous fixation or external support as indicated for stability, confirmation of alignment without formal manipulation, and intraoperative imaging to document fracture position. Post-procedure, the patient is observed in PACU, instructed on weight-bearing status (often protected or partial weight bearing), provided pain control, and scheduled for radiographic follow-up to monitor healing.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier | Use when no specific modifier applies and standard billing is appropriate |