CPT 27220
Global 090 ActiveTreat hip socket fracture
CPT 27220 Billing & Documentation Guide
CPT code 27220 (Treat hip socket fracture) is classified under Surgery (Musculoskeletal) with a global period indicator of 090. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 5.36, a non-facility practice expense RVU of 7, and a malpractice RVU of 1.14, a total non-facility RVU of 13.5 and facility RVU of 11.69. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $459.29, though rates vary from $399.48 to $556.28 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 27220, ensure documentation supports medical necessity and the specific components required for the code's level of service. For E/M codes, document MDM (medical decision-making) elements: problems addressed, data reviewed, and risk. For procedural codes, document the indication, technique, and any complications. Always verify NCCI edits before bundling 27220 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
90-day global period (major surgery: 1 day pre-op + procedure + 90 days post-op)
MUE Limit (Medically Unlikely Edits)
Submitting more than 1 units of 27220 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.
RVU Breakdown, CPT 27220
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 5.36 | 5.36 |
| Practice Expense RVU | 7 | 5.19 |
| Malpractice RVU | 1.14 | 1.14 |
| Total RVU | 13.5 | 11.69 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 27220
State-level averages across all MAC localities. Non-facility rates typically apply to office-based services; facility rates apply to hospital outpatient / inpatient.
| State | Non-Facility | Facility | Range (Non-Fac) | Localities |
|---|---|---|---|---|
| California | $482.75 | $411.21 | $458.73 - $556.28 | 29 |
| Florida | $487.74 | $427.08 | $459.78 - $518.72 | 3 |
| Georgia | $447.91 | $390.24 | $432.97 - $462.84 | 2 |
| Illinois | $478.33 | $419.92 | $452.01 - $502.64 | 4 |
| Michigan | $452.17 | $395.4 | $435.48 - $468.85 | 2 |
| North Carolina | $421.5 | $365.1 | $421.5 - $421.5 | 1 |
| New York | $500.12 | $432.67 | $427.91 - $539.19 | 5 |
| Ohio | $430.88 | $375.68 | $430.88 - $430.88 | 1 |
| Pennsylvania | $450.36 | $391.15 | $429.65 - $471.07 | 2 |
| Texas | $445.56 | $386.05 | $427.17 - $465.02 | 8 |
Source: CMS PFSRVU 2026 · Updated 2026-04-01. Full locality-level detail available for all 53 states, contact us for custom reports.
NCCI Bundling Edits, CPT 27220
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 27220 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 01995 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 0213T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0216T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0228T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 0230T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 0566T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0596T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0597T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0708T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0709T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
Frequently Asked Questions, CPT 27220
What does CPT code 27220 mean? +
CPT code 27220 represents: Treat hip socket fracture. It's in the Surgery (Musculoskeletal) category with a global period of 090.
What is the Medicare reimbursement for CPT 27220? +
The 2026 Medicare national average non-facility payment for CPT 27220 is $459.29. Rates range from $399.48 to $556.28 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 27220? +
Surgery codes commonly use modifier 22 (increased procedural services), 50 (bilateral), 51 (multiple procedures), 52 (reduced services), 58/78/79 (staged, unplanned return, unrelated within global), 62 (co-surgeons), 80/82 (assistant surgeon), and 59 or the X{EPSU} subset for distinct procedural service.
What bundling edits apply to CPT 27220? +
This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
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