CPT code 27178: SCFE surgery, osteotomy with fixation2026 Medicare rate & RVUs

Medicare pays $856.73 for 27178 nationally in a facility.

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 27178 covers

This code is for open surgery to treat slipped capital femoral epiphysis (SCFE) that includes a corrective osteotomy of the proximal femur. The operation is generally performed by an orthopedic surgeon, often for an adolescent whose femoral head has displaced at the growth plate and requires operative correction. The operative report should make clear that treatment included the osteotomy, not just closed reduction or a different open treatment approach.

Report the code when the documented procedure matches that osteotomy-based treatment; include the affected side and describe the correction and any fixation performed. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. For bilateral procedures reported with modifier 50, CMS pays at 150%. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to a 50% reduction. An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation, and team surgery is not permitted.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

Where 27178 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

27178 rates by state

Office rate range in each state. Select a state to see its payment localities.

How the 27178 rate is calculated

Each of 27178’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

Payment rules and modifiers for 27178

27178 has a 90-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 50

27178 compared with similar codes

How to choose

27177Slipped epiphysisAcute, open treatment

Choose 27178 for open SCFE treatment with corrective osteotomy. Choose 27177 when the open treatment involves proximal femoral epiphysiodesis.

27175Slipped epiphysis treatmentWithout manipulation

27175 is closed treatment without manipulation. It does not describe the open osteotomy-based operation reported with 27178.

27176Slipped epiphysis treatmentClosed, with manipulation

27176 is closed treatment with manipulation, with or without skeletal traction. The open corrective osteotomy in 27178 distinguishes that code.

27181Femoral osteotomyNeck, slipped epiphysis

27181 describes femoral neck osteotomy for SCFE. Compare the documented operative method and scope with the open treatment represented by 27178.

Codes related to 27178

Related codes aren’t interchangeable: bill the code that matches the service performed.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Open CMS sourceHow we calculate rates