CPT 27236 Surgery

How Much Does Open treatment of femoral fracture Cost?

Open treatment of femoral fracture (CPT 27236) costs $1,025 at Medicare rates. Hospital outpatient rate: $7.

Cost Comparison by Payer

How much Open treatment of femoral fracture costs across different settings and payers

Medicare
Facility rate
$1,025
Hospital Outpatient
OPPS rate
$7
Surgery Center
ASC rate
$4
Medicare (Facility)
$1,025
CMS PFS 2026 national rate
Hospital Outpatient
$7
OPPS rate
Surgery Center (ASC)
$4
Ambulatory surgery center

Open treatment of femoral fracture Cost by Location

Medicare-adjusted rates across CMS localities

Location Medicare Rate Est. Commercial
AK — ALASKA $1,355 $1,761 — $2,710
AL — ALABAMA $993 $1,291 — $1,986
AR — ARKANSAS $980 $1,275 — $1,961
AZ — ARIZONA $1,066 $1,385 — $2,131
CA — BAKERSFIELD $1,097 $1,426 — $2,194
CA — CHICO $1,087 $1,413 — $2,174
CA — EL CENTRO $1,088 $1,414 — $2,175
CA — FRESNO $1,087 $1,413 — $2,174
CA — HANFORD-CORCORAN $1,087 $1,413 — $2,174
CA — LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) $1,151 $1,496 — $2,302
CA — MADERA $1,087 $1,413 — $2,174
CA — MERCED $1,087 $1,413 — $2,174
CA — MODESTO $1,087 $1,413 — $2,174
CA — NAPA $1,198 $1,558 — $2,397
CA — OXNARD-THOUSAND OAKS-VENTURA $1,138 $1,480 — $2,276
CA — REDDING $1,087 $1,413 — $2,174
CA — REST OF CALIFORNIA $1,087 $1,413 — $2,174
CA — RIVERSIDE-SAN BERNARDINO-ONTARIO $1,126 $1,464 — $2,252
CA — SACRAMENTO-ROSEVILLE-FOLSOM $1,125 $1,462 — $2,249
CA — SALINAS $1,120 $1,456 — $2,240
CA — SAN DIEGO-CHULA VISTA-CARLSBAD $1,135 $1,476 — $2,270
CA — SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) $1,248 $1,622 — $2,495
CA — SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) $1,243 $1,617 — $2,487
CA — SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) $1,278 $1,662 — $2,557
CA — SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) $1,261 $1,640 — $2,523

How to Reduce Your Cost for Open treatment of femoral fracture

Practical tips that can save you hundreds or thousands of dollars

  • 1
    Ask about cash-pay discounts

    Many hospitals and clinics offer 20-40% discounts for self-pay patients. Always ask before scheduling.

  • 2
    Compare facility vs. office setting costs

    Some procedures cost significantly less in an office setting than a hospital. Ask your provider about options.

  • 3
    Shop around — costs vary significantly

    Medicare rates for this procedure range from $980 to $1,355 depending on location. Commercial rates vary even more.

  • 4
    Check ambulatory surgery centers (ASCs)

    This procedure is available at ASCs for $4, compared to $7 at hospital outpatient departments. ASCs often offer lower costs with comparable quality.

How is the Price Calculated?

Medicare calculates procedure payments using Relative Value Units (RVUs). Each procedure has three components multiplied by a conversion factor ($33.40 in 2026) and adjusted by geographic cost indices.

18.37
Work RVU
9.85
Practice Expense RVU
3.45
Malpractice RVU

Payment = Total RVU () x CF ($33.40) = N/A

Frequently Asked Questions

How much does Open treatment of femoral fracture cost?

The Medicare facility rate for Open treatment of femoral fracture is $1,025. In a hospital outpatient setting, the rate is $7. At an ambulatory surgery center, the rate is $4. Commercial insurance rates typically range from 150% to 250% of Medicare (varies by plan).

How much does Open treatment of femoral fracture cost without insurance?

Without insurance, the cost of Open treatment of femoral fracture can range from 150% of Medicare to 500% of Medicare depending on the facility. Many hospitals and clinics offer self-pay discounts of 20-40% off their chargemaster price. Always ask about cash pricing before your visit.

Does insurance cover Open treatment of femoral fracture?

Most commercial health insurance plans and Medicare cover Open treatment of femoral fracture when ordered by a physician for a medically necessary reason. Your out-of-pocket cost depends on your plan's deductible, copay/coinsurance structure, and whether you use an in-network provider. Check with your insurance company before scheduling to confirm coverage and get a cost estimate.

Why does the cost vary so much by location?

Medicare adjusts payments using Geographic Practice Cost Indices (GPCIs) that reflect local differences in physician work costs, practice expenses, and malpractice insurance. Manhattan, San Francisco, and other high-cost areas pay significantly more than rural regions. Commercial insurers follow similar geographic patterns.

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