CPT code 27181: Femoral osteotomy, neck, slipped epiphysis2026 Medicare rate & RVUs in Maryland
Reports a femoral neck osteotomy to correct deformity associated with slipped capital femoral epiphysis, rather than traction or pinning in situ.
CMS doesn’t publish an office rate for 27181 in Maryland.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
Your location
On this page 9 sections
What 27181 covers
This procedure surgically cuts the femoral neck to correct alignment in a patient with slipped capital femoral epiphysis. Orthopedic surgeons typically perform it in an operating room when the deformity calls for osteotomy rather than treatment by traction or pinning in situ. The operative report should identify the affected side, femoral neck osteotomy, the deformity being corrected, and the correction performed.
Report the code for the femoral neck osteotomy, not simply because the patient has a slipped epiphysis; documentation should support the procedure actually performed. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple-procedure reduction. Bilateral reporting with modifier 50 is paid at 150%. An assistant at surgery may be paid; co-surgeons and team surgery are 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 27181 pays more and less in Maryland
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Baltimore area, MD | Unavailable | $1,096.10 |
| Rest of Maryland | Unavailable | $1,033.24 |
| Washington, DC area | Unavailable | $1,143.56 |
How the 27181 rate is calculated
Each of 27181’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 · 27181
RVUs × geographic indexes × conversion factor
Work15.78
15.78 RVUs× 1.000 GPCI
Practice expense11.78
11.78 RVUs× 1.000 GPCI
Malpractice3.35
3.35 RVUs× 1.000 GPCI
Adjusted RVUs
30.9100
Conversion factor
$33.4009
Medicare rate
$1,032.42
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 27181
27181 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 27181
Femoral osteotomy, neck, slipped epiphysis
| 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) | 0 | Not permitted. |
| 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 · 27181
Femoral osteotomy, neck, slipped epiphysis
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
27181 without 50 · national facility
$1,032.42
Femoral osteotomy, neck, slipped epiphysis
27181-50 · Bilateral: 150%
$1,548.63
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).
27181 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 27176Slipped epiphysis treatmentClosed, with manipulation
- 27176 describes pinning the epiphysis in situ. Use 27181 when the documented procedure is a femoral neck osteotomy to correct alignment.
- 27175Slipped epiphysis treatmentWithout manipulation
- 27175 describes treatment by traction without reduction. It does not describe a femoral neck osteotomy.
- 27177Slipped epiphysisAcute, open treatment
- Both codes are in the slipped-epiphysis treatment family. Select 27181 when the operative documentation supports a femoral neck osteotomy; use 27177 for its specified osteotomy-based treatment.
27181 billing questions
How does this differ from pinning in situ?
Use 27181 when the surgeon performs a femoral neck osteotomy to correct alignment. Code 27176 describes treatment by pinning in situ, rather than osteotomy.
Is 27181 the code for every slipped epiphysis?
No. The operative method determines the code. This code describes femoral neck osteotomy, not treatment by traction or pinning in situ.
What documentation supports 27181?
The operative report should document the femoral neck osteotomy, the side treated, the slipped-epiphysis deformity, and the correction performed.
How is bilateral surgery reported?
CMS identifies this as a bilateral procedure. When reported with modifier 50, payment is at 150%.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. CMS does not permit co-surgeons or team surgery for this code.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
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
Show the CMS file lines behind this rate
Fee sheets · Coming soon
Put 27181 and the rest of your codes on one sheet
Your codes at your locality, with payer contracts beside Medicare.
Join the waitlist