How much does Medicare pay for CPT 27236?

Medicare allowed an average of $983.38 per service and paid $781.52 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $4279.14, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 27236?

Treatment of upper end of broken thigh bone with placement of stabilizing device or prosthetic replacement. It was billed 26,338 times to 26,157 Medicare beneficiaries by 1,541 providers in 2024.

Which specialty bills 27236 most?

Orthopedic Surgery, with 21,348 services from 1,238 clinicians. Next are Physician Assistant, Nurse Practitioner, Sports Medicine.

CPT 27236

Treatment of upper end of broken thigh bone with placement of stabilizing device or prosthetic replacement

$983.38Medicare-allowed amount per service, averaged across 26,338 services

Providers submitted

$4279.14

Asking price, not received

Medicare allowed

$983.38

The fee schedule figure

Medicare paid

$781.52

Balance is patient coinsurance

Providers submitted an average of $4279.14 for this code and Medicare allowed $983.38 — 4.4× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $781.52 (79%); the rest is the patient’s coinsurance and deductible.

Services: 26,338
Beneficiaries: 26,157
Providers billing it: 1,541
Total allowed: $25,900,262

What Medicare pays for CPT 27236

Across 26,338 services billed by 1,541 providers to 26,157 beneficiaries, Medicare allowed an average of $983.38 per service. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 27236

Specialty	Services	Beneficiaries	Avg allowed	Providers
Orthopedic Surgery	21,348	21,202	$1160.54	1,238
Physician Assistant	3,972	3,944	$158.56	243
Nurse Practitioner	627	624	$157.36	37
Sports Medicine	223	222	$1130.29	13
Hand Surgery	67	66	$1153.36	5
General Surgery	30	30	$218.60	1
Emergency Medicine	25	25	$1101.15	1
Family Practice	19	18	$188.65	1
Osteopathic Manipulative Medicine	16	15	$1038.17	1
Internal Medicine	11	11	$1172.02	1

27236 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
Florida	3,622	$928.20	$709.49	202
California	2,346	$1041.44	$787.93	135
Texas	2,147	$968.59	$778.26	127
New York	1,091	$1232.47	$858.21	61
Arizona	1,088	$867.56	$701.09	62
Virginia	938	$1027.84	$819.72	55
Illinois	729	$1084.27	$808.62	42
Pennsylvania	721	$1057.82	$843.35	44
South Carolina	707	$1030.82	$845.25	38
Ohio	704	$1010.03	$824.81	45
Oklahoma	701	$985.88	$834.00	39
Tennessee	692	$1011.85	$871.09	41
New Jersey	678	$1111.39	$820.54	40
Missouri	656	$981.68	$807.63	38
North Carolina	629	$1017.56	$839.11	34
Arkansas	590	$841.60	$745.88	35
Maryland	574	$1163.05	$876.51	34
Georgia	571	$1026.31	$822.43	35
Louisiana	554	$797.13	$651.65	33
Indiana	519	$807.58	$687.23	36
Washington	467	$913.70	$719.83	29
Massachusetts	444	$1138.73	$856.56	28
Michigan	411	$1142.88	$891.47	25
Mississippi	406	$1005.70	$869.86	23
Iowa	394	$762.90	$637.20	17
Kansas	393	$892.29	$770.25	18
Minnesota	326	$974.57	$800.73	22
Nevada	300	$962.92	$781.29	13
Kentucky	281	$970.54	$814.13	19
Alabama	270	$817.87	$707.97	19
South Dakota	261	$783.53	$663.97	17
Colorado	230	$1121.87	$884.09	16
North Dakota	218	$912.28	$733.74	9
Delaware	201	$839.47	$670.04	11
Wisconsin	174	$947.59	$802.89	13
West Virginia	162	$988.16	$786.07	10
New Hampshire	142	$899.42	$706.08	9
Utah	116	$787.87	$653.60	8
Nebraska	115	$868.27	$747.11	7
Oregon	111	$896.09	$732.25	8
Connecticut	109	$825.82	$614.84	7
New Mexico	109	$1047.81	$829.73	8
Maine	108	$885.33	$725.25	8
Montana	97	$833.54	$657.59	6
Wyoming	58	$692.76	$564.50	4
Idaho	48	$1084.61	$935.57	2
District of Columbia	32	$562.55	$401.55	2
Hawaii	32	$1175.37	$938.79	2
Alaska	26	$811.30	$535.07	2
Vermont	24	$1096.63	$918.33	2
Rhode Island	16	$1180.87	$929.04	1

Related codes

27245Treatment of broken neck of thigh bone$1034.24
27279Fusion of pelvic joint$5445.92
27280Fusion of sacroiliac joint between spine and pelvis$1317.55

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.