CPT 27245 Surgery - Musculoskeletal

How Much Does Hip Fracture Repair with Nail or Plate Cost?

Also known as: Treat thigh fracture (CPT 27245)

Surgery to repair a broken hip bone using metal hardware like nails, screws, or plates.

The total estimated cost of Hip Fracture Repair with Nail or Plate (CPT 27245) is $3,758 to $7,046, including hospital fees, anesthesia, and supplies. The surgeon's Medicare fee alone is $1,118.

Total Estimated Cost of Care

$3,758 — $7,046

This estimate includes hospital facility fees, anesthesia, and supplies .

Surgeon/Physician Fee
$1,118
Hospital Facility Fee
$3,355
Anesthesia (est.)
$224
Important: The physician fee of $1,118 shown in the cost cards below is what Medicare pays the surgeon/doctor only. The hospital charges a separate facility fee that typically makes up 70-85% of the total cost.
Medicare Physician Fee (Facility Setting)
$1,118
Physician component only — CMS PFS 2026

Patient Guide: Hip Fracture Repair with Nail or Plate

What you need to know before your appointment

What to Expect

Under anesthesia, the surgeon realigns the broken bone and secures it with metal hardware. Hospital stay is typically 2-5 days.

How Long Does It Take?

1-2 hours surgery, 2-5 days hospital stay

Common Reasons Doctors Order This

Hip fracture from fall, broken hip, femur fracture near the hip

How to Prepare

This is usually emergency surgery. Follow staff instructions. Tell doctors about all medications, especially blood thinners.

Procedures Commonly Done Together

These procedures are frequently performed alongside Treat thigh fracture

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What Insurance Companies Actually Pay

Real negotiated rates from 9 hospitals across 4 states (from hospital price transparency filings)

Lowest
$1
Highest
$16,776
Average
$5,606
Insurance Company Avg Rate Range Hospitals
Aetna $4,444 $2,089 - $11,593 7
Cigna $7,253 $1,333 - $16,776 9
United $7,064 $3,566 - $11,924 9
Superior Health Plan $948 $948 3
BCBS $13,831 $11,729 - $15,041 3
BCBS-TX $1,790 $959 - $2,456 2
Humana $4,055 $2,204 - $4,690 6
Anthem $7,643 $4,765 - $10,063 2
BCBS - TN $595 $167 - $2,207 2
Multiplan $10,478 $10,478 2
Evry Health $2,431 $2,431 3
Healthcare Highways $2,434 $2,434 3
Average by State
GA: $2,324 (9) TN: $2,640 (11) TX: $5,434 (133) CO: $8,109 (34)
Disclaimer: These rates are from hospital Machine-Readable Files (MRFs) required by federal price transparency law. They reflect specific hospital-payer contracts and may not represent your actual cost, which depends on your plan, deductible, and network status. Data sourced from CommonSpirit Health, HCA Healthcare, and Kaiser Permanente filings.

How to Reduce Your Cost for Treat thigh 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

    Costs can vary 2-3x between providers in the same city. Get quotes from multiple facilities.

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.

17.73
Work RVU
12.04
Practice Expense RVU
3.71
Malpractice RVU
33.48
Total RVU

Payment = Total RVU (33.48) x CF ($33.40) = $1,118

Frequently Asked Questions

How much does Treat thigh fracture cost?

The Medicare facility rate for Treat thigh fracture is $1,118. Commercial insurance rates typically range from 150% to 250% of Medicare (varies by plan).

How much does Treat thigh fracture cost without insurance?

Without insurance, the cost of Treat thigh 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 Treat thigh fracture?

Most commercial health insurance plans and Medicare cover Treat thigh 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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