CPT 27268: Closed Reduction of Femoral Neck/Head Fracture - OpenPayer

Summary & Overview

CPT 27268: Closed Reduction of Femoral Neck/Head Fracture

CPT code 27268 represents the closed (non‑open) manual or instrumented reduction of a femoral neck or head fracture. This procedure code is used when a provider realigns a fractured proximal femur through manipulation without making an incision, typically in urgent or emergent orthopedic settings. Nationally, accurate use of this code matters for appropriate clinical documentation, care coordination after major lower‑extremity trauma, and linkage to post‑acute services.

Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context for CPT code 27268, typical sites of service, and which payers frequently cover or adjudicate these services. The publication also summarizes common billing considerations and the types of benchmarks and policy updates relevant to facilities and orthopedic providers.

The report is intended to help coding managers, hospital billing teams, and orthopedic department leaders understand the role of CPT code 27268 in trauma care workflows, identify documentation elements that support correct coding, and review payer coverage patterns and claims handling implications. Data not available in the input are noted where applicable.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareCPT 27268femoral neck fractureclosed reductionorthopedic surgerytrauma carehospital billingprocedure codingfracture managementacute care

Billing Code Overview

CPT code 27268 describes a closed treatment of a femoral neck (head of the femur) fracture by manipulation without incision. The procedure involves realignment of the fractured femoral head or neck using manual or instrumented manipulation without making an open surgical incision.

Service type: Closed fracture reduction

Typical site of service: Hospital inpatient or emergency department; may also occur in ambulatory surgical centers depending on clinical severity and setting

Clinical & Coding Specifications

Clinical Context

A typical patient is an adult who sustains a displaced femoral neck or intertrochanteric fracture after a fall or high-energy trauma and presents to the emergency department or orthopedic trauma service. The patient reports acute hip pain, inability to bear weight, and has localized tenderness and limited range of motion on exam. Radiographs (AP pelvis and lateral hip) confirm a femoral head or proximal femur fracture appropriate for a closed manipulation (attempted closed reduction) rather than immediate open surgical fixation. The clinical workflow includes initial triage and analgesia, neurovascular assessment, pre-procedure consent and sedation planning, application of conscious sedation or regional anesthesia, fluoroscopic guidance for closed reduction/manipulation of the femoral head/neck, post-reduction imaging to confirm alignment, and admission for definitive management (which may include internal fixation or arthroplasty). Documentation must include indication for closed manipulation, sedation/anesthesia used, technique and maneuvers performed, fluoroscopic findings, post-procedure neurovascular status, and disposition.

Coding Specifications

Modifier	Description	When to Use
`00`	No modifier; standard reporting	Use when no modifier is applicable and service is routine.
`11`

CPT 27228: Open Treatment of Complex Acetabular Fracture

cpt-27254-open-treatment-hip-dislocation-acetabular-femoral-fracture

CPT 27254: Open Treatment of Traumatic Hip Dislocation with Fracture

cpt-27200-closed-treatment-coccyx-fracture

CPT 27200: Closed Treatment of Coccyx (Tailbone) Fracture

cpt-27232-closed-treatment-femoral-neck-fracture

CPT 27232: Closed Treatment of Femoral Neck Fracture

cpt-27244-femoral-fracture-plate-and-screw-fixation-open-treatment

CPT 27244: Open Femoral Fracture Fixation with Plate and Screws

cpt-27252-closed-reduction-traumatic-hip-dislocation-general-anesthesia

CPT 27252: Closed Reduction of Traumatic Hip Dislocation under General Anesthesia

cpt-27266-closed-reduction-prosthetic-hip-dislocation

CPT 27266: Closed Reduction of Dislocated Prosthetic Hip

cpt-27230-closed-treatment-femoral-neck-fracture

CPT 27230: Closed Treatment of Femoral Neck Fracture

cpt-27253-open-treatment-hip-joint-dislocation-no-fixation

CPT 27253: Open Treatment of Hip Joint Dislocation, No Internal Fixation

cpt-27198-pelvic-ring-manipulation-under-anesthesia

CPT 27198: Closed Manipulation of Posterior Pelvic Fracture Under Anesthesia

Showing 1–10 of 35

Taxonomy Code	Specialty	Notes
207X00000X	Orthopaedic Surgery	Primary specialty performing closed reduction for femoral head/neck fractures.
208000000X	General Surgery	May be involved in trauma systems or combined surgical management.
2086S0122X	Emergency Medicine	Initial reduction attempts in the emergency department under sedation may be performed by emergency physicians.
363L00000X	Anesthesiology	Provides sedation or regional anesthesia for closed manipulation procedures.
207L00000X	Orthopaedic Trauma Surgery	Subspecialty focused on complex proximal femur fracture management.

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 diagnosis indicating a femoral neck fracture appropriate for closed reduction attempts.
`S72.002A`	Fracture of unspecified part of neck of left femur, initial encounter for closed fracture	Left-sided femoral neck fracture that may be managed with closed manipulation.
`S72.101A`	Fracture of intertrochanteric section of right femur, initial encounter for closed fracture	Intertrochanteric fractures often require reduction; initial closed attempts are common.
`S72.102A`	Fracture of intertrochanteric section of left femur, initial encounter for closed fracture	Left intertrochanteric fracture relevant for closed reduction technique.
`S72.031A`	Displaced fracture of head of right femur, initial encounter for closed fracture	Displaced femoral head fractures where closed manipulation may be attempted.
`S72.032A`	Displaced fracture of head of left femur, initial encounter for closed fracture	Left femoral head displaced fracture amenable to closed reduction in selected cases.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`27235`	Open treatment of femoral shaft fracture, with or without internal fixation	May be performed if closed manipulation fails and open fixation is required as definitive management.
`27236`	Open treatment of femoral neck fracture, with internal fixation or prosthetic replacement	Definitive surgical fixation or arthroplasty following initial closed reduction attempts.
`27244`	Open treatment of intertrochanteric, peritrochanteric, or subtrochanteric femoral fracture with internal fixation	Used when open internal fixation is indicated after closed reduction or as primary treatment.
`20690`	Drainage of hematoma, seroma, or fluid collection (eg, needle aspiration)	May be performed perioperatively for associated soft-tissue collections.
`77002`	Fluoroscopic guidance for extremity fracture reduction	CPT for fluoroscopic guidance used during closed manipulation to confirm reduction and guide maneuvers.

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