CPT code 27178: SCFE surgery, osteotomy with fixation2026 Medicare rate & RVUs in Illinois
Reports open operative treatment of slipped capital femoral epiphysis when the surgeon performs a corrective osteotomy, with fixation as indicated.
CMS doesn’t publish an office rate for 27178 in Illinois.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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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 in Illinois
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Chicago, IL | Unavailable | $977.33 |
| East St. Louis, IL | Unavailable | $919.79 |
| Rest of Illinois | Unavailable | $877.00 |
| Suburban Chicago, IL | Unavailable | $938.14 |
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.
How the rate is built · 27178
RVUs × geographic indexes × conversion factor
Work12.60
12.60 RVUs× 1.000 GPCI
Practice expense10.37
10.37 RVUs× 1.000 GPCI
Malpractice2.68
2.68 RVUs× 1.000 GPCI
Adjusted RVUs
25.6500
Conversion factor
$33.4009
Medicare rate
$856.73
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 27178
27178 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 27178
SCFE surgery, osteotomy with fixation
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.69/0.21 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 27178
SCFE surgery, osteotomy with fixation
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
27178 without 50 · national facility
$856.73
SCFE surgery, osteotomy with fixation
27178-50 · Bilateral: 150%
$1,285.10
Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).
27178 compared with similar codes
Compare codes · National
5 codes, side by side
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.
27178 billing questions
How does this differ from 27177?
27178 describes open SCFE treatment with a corrective osteotomy. 27177 is the open treatment approach involving proximal femoral epiphysiodesis.
When would 27175 or 27176 be more appropriate?
Those codes describe closed treatment: 27175 without manipulation and 27176 with manipulation, with or without skeletal traction. Use 27178 when the documented operation includes open treatment with osteotomy.
Does the code include postoperative visits?
CMS assigns a 90-day global period. The day-before preoperative visit and related postoperative care during the 90 days are included.
Can modifier 50 be used for bilateral treatment?
CMS lists this as a bilateral procedure; with modifier 50, it is paid at 150%. The record should support treatment of both sides.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery services may be paid. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
What documentation supports reporting 27178?
The operative report should identify SCFE and describe the open corrective osteotomy, the side treated, and any fixation performed. The documented procedure must distinguish it from closed treatment or open treatment using another approach.
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
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