Summary & Overview

CPT 27248: Open Treatment of Greater Trochanteric Femur Fracture

CPT code 27248 represents an open surgical procedure to treat a greater trochanteric fracture of the proximal femur using internal fixation devices such as pins or screws. This code captures definitive operative management of femoral trochanteric fractures, a clinically significant intervention due to its impact on mobility, complication risk, and post-acute care needs. Nationally, procedures coded with CPT code 27248 are relevant to hospital surgical volumes, orthopaedic trauma care pathways, and surgical quality measurement.

Key payers considered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of where CPT code 27248 is used clinically, common sites of service, and the procedural context for orthopaedic surgeons and hospital administrators. The publication highlights benchmarking metrics, reimbursement considerations, and any notable policy updates that affect surgical fracture fixation coding and payment across major national payers.

This summary provides clinical context for coding and billing teams, revenue cycle managers, and clinical leaders who oversee orthopaedic trauma services, enabling clearer understanding of when CPT code 27248 is appropriate and how it fits into broader surgical and payer landscapes.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareCPT 27248orthopedic surgeryfracture fixationproximal femurtrochanteric fracturesurgical procedurehospital inpatientoperative management

Billing Code Overview

CPT code 27248 describes an open treatment of a greater trochanteric fracture of the proximal femur. The procedure involves surgical exposure of the fracture and stabilization of the bone, commonly using internal fixation implants such as pins or screws.

Service Type: Open surgical fracture fixation of the proximal femur

Typical Site of Service: Hospital inpatient or hospital outpatient surgical setting (operating room)

Data not available in the input.

Clinical & Coding Specifications

Clinical Context

A 72-year-old ambulatory female presents to the emergency department after a ground-level fall at home with acute right lateral hip pain, inability to bear weight, and visible shortening of the right lower extremity. Radiographs demonstrate a displaced intertrochanteric fracture involving the greater trochanter and lateral femoral cortex. The orthopedic trauma surgeon plans an open reduction and internal fixation using screws and a side plate or intramedullary device, billed as 27248. Preoperative evaluation includes medical clearance, anesthesia assessment, and informed consent. The procedure is performed in an inpatient or ambulatory surgery center operating room under general or regional anesthesia. Postoperative workflow includes immediate PACU recovery, pain management, venous thromboembolism prophylaxis, physical therapy initiation with protected weight-bearing as indicated, wound checks, and outpatient follow-up for radiographic healing and hardware assessment.

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component	Use when only the surgeon's professional component is billed separate from a facility technical component.
`50`	Bilateral procedure	Use if both left and right greater trochanteric regions are surgically treated during the same operative session.
`51`	Multiple procedures	Use when `27248` is one of multiple distinct procedures performed at the same operative session.
`52`	Reduced services	Use when the surgeon documents that the procedure was partially reduced or not completed as planned.
`53`	Discontinued procedure	Use if the procedure is started but terminated due to extenuating circumstances before completion.
`59`	Distinct procedural service	Use to indicate a separate and distinct procedure or service not normally billed together when appropriate and supported by documentation.
`62`	Two surgeons	Use when two surgeons with different specialties actively perform distinct portions of the procedure (e.g., complex reconstruction with consultant).
`66`	Surgical team approach	Use when a surgical team is documented and appropriate for a high-complexity case requiring multiple surgeons.
`78`	Return to OR for related procedure during global period	Use for an unplanned return to the operating room for a related procedure during the global postoperative period.
`79`	Unrelated procedure or service during global period	Use when an unrelated procedure is performed during the global period (note: `79` is not in the provided list; therefore not listed).
`L T`	Left side	Use to designate the left side when the procedure is performed on the left greater trochanter.
`R T`	Right side	Use to designate the right side when the procedure is performed on the right greater trochanter.
`AS`	Ambulatory surgery center facility	Use to identify services performed in an ambulatory surgery center setting when billing requires the `AS` modifier.
`QK`	Medical direction of 2–4 CRNAs by anesthesiologist	Use when the anesthesiologist medically directs multiple CRNAs for the case.

Taxonomy Code	Specialty	Notes
207X00000X	Orthopaedic Surgery	Primary specialty that performs open fixation of proximal femur fractures.
208000000X	General Surgery	May be involved in trauma settings or when orthopedics is not available.
207L00000X	Orthopedic Trauma Surgery	Subspecialty focusing on complex fractures and perioperative care.
208100000X	Surgical Critical Care	Manages critically ill trauma patients perioperatively when indicated.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`S72.141A`	Displaced fracture of greater trochanter of right femur, initial encounter for closed fracture	Common diagnosis indicating an acute displaced greater trochanteric fracture appropriate for open fixation with `27248`.
`S72.142A`	Displaced fracture of greater trochanter of left femur, initial encounter for closed fracture	Left-sided equivalent when surgical fixation is performed on the left side.
`S72.141B`	Displaced fracture of greater trochanter of right femur, initial encounter for open fracture	Applies when the fracture is open and requires operative care and soft-tissue management.
`S72.149A`	Unspecified fracture of upper end of right femur, initial encounter for closed fracture	Used when documentation describes proximal femur fracture without further anatomic detail; may support operative fixation.
`S72.151A`	Intertrochanteric fracture of right femur, initial encounter for closed fracture	Intertrochanteric patterns commonly involve the greater trochanter and may be managed with internal fixation techniques similar to `27248`.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`27245`	Open treatment of femoral neck fracture, proximal femur; internal fixation or prosthetic replacement	Performed for proximal femoral fractures when fracture extends into the femoral neck or requires alternative fixation strategy.
`27244`	Open treatment of femoral shaft fracture, intramedullary implant, with or without cerclage	Used when fracture pattern extends into the shaft and requires intramedullary fixation beyond proximal constructs.
`27506`	Open treatment of proximal femoral fracture, proximal femur, internal fixation, peritrochanteric or subtrochanteric region	Used for adjacent proximal femoral fracture patterns; may be performed alongside or instead of `27248` depending on fracture location.
`11042`	Debridement including removal of foreign material, muscle and fascia (2 layers)	May be reported if extensive debridement of soft tissue or wound management is required during the same operative session.
`20680`	Removal of deep implant; complicated	Billed if previously placed hardware in the proximal femur is removed during the same surgery prior to fixation with new implants.