Billing code 27146: Hip osteotomyMedicare rate & RVUs

Medicare pays $1,169.03 for 27146 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 27146 covers

The surgeon cuts and repositions part of the pelvis to improve the position or coverage of the hip socket. Orthopedic surgeons commonly perform this operation for hip-preservation needs, including acetabular dysplasia; pediatric cases may involve developmental hip conditions. A Salter-type pelvic osteotomy is a familiar example. The code represents the pelvic bone work, not an osteotomy confined to the femur.

Select the code from the operative report’s description of the bone treated and the procedures performed. Document the indication, laterality, pelvic bone work, and whether a femoral osteotomy was also performed; the combined pelvic and femoral procedure is distinguished by 27147. This major surgery has a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be made; 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 27146 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

27146 rates by state

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

How the 27146 rate is calculated

Each of 27146’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 27146

27146 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

27146 compared with similar codes

How to choose

27147Hip osteotomy

27147 describes the pelvic osteotomy performed with a femoral osteotomy. Use 27146 when the documented work is limited to the pelvic bone.

27161Femoral osteotomy

27161 is directed to an osteotomy of the femoral neck. Code 27146 is for osteotomy of the iliac, acetabular, or innominate bone.

27165Femoral osteotomy

27165 concerns femoral osteotomy with fixation; 27146 concerns pelvic bone osteotomy.

27130Hip replacement

27130 reports total hip arthroplasty, which replaces the hip joint. Code 27146 reports pelvic bone realignment rather than joint replacement.

Codes related to 27146

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