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CPT code 27147: Hip osteotomy2026 Medicare rate & RVUs

Reports corrective hip-bone realignment that includes osteotomies of both the pelvis and femur, commonly for structural hip deformity or developmental dysplasia.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare pays $1,326.02 for 27147 nationally in a facility.

Medicare rate · 27147

Hip osteotomy

Office or facility?

Work RVUs
21.52
Total RVUs
39.70
Global days
090

National rate · 2026

$1,326.02

Facility setting, before claim adjustments.

See every locality for 27147 →Billed by an NP, PA or therapist? →

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

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What 27147 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 27147 covers

This code describes a reconstructive operation combining an osteotomy of the iliac, acetabular, or innominate bone with a femoral osteotomy to improve hip alignment or joint coverage. Orthopedic surgeons most often perform it for significant structural deformity, including selected cases of developmental hip dysplasia. The operative report should identify the pelvic and femoral work performed and the side treated; the code represents the combined procedure rather than an isolated pelvic osteotomy.

Report it when both components are performed in the same operative session. Documentation should support the deformity being corrected, the specific bones and osteotomies, and laterality. It has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be allowed; co-surgeon payment requires supporting documentation. 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 27147 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

27147 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$1,202.84
AlaskaUnavailable$1,646.25
ArizonaUnavailable$1,289.91
ArkansasUnavailable$1,187.77
Atlanta, GAUnavailable$1,366.19
Austin, TXUnavailable$1,336.36
Bakersfield, CAUnavailable$1,323.47
Baltimore area, MDUnavailable$1,406.93
Beaumont, TXUnavailable$1,274.27
Brazoria, TXUnavailable$1,294.02

27147 rates by state

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

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Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

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27147 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 27147 rate is calculated

Each of 27147’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 · 27147

RVUs × geographic indexes × conversion factor

Office or facility?

Work21.52

21.52 RVUs× 1.000 GPCI

Practice expense13.60

13.60 RVUs× 1.000 GPCI

Malpractice4.58

4.58 RVUs× 1.000 GPCI

Adjusted RVUs

39.7000

Conversion factor

$33.4009

Medicare rate

$1,326.02

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 27147

27147 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 27147

Hip osteotomy

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
Assistant at surgery (80/81/82/AS)2Paid.
Co-surgeons (62)1Permitted with supporting documentation.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.69/0.21Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 27147

Hip osteotomy

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.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 50 · payment effect

With and without the modifier

27147 without 50 · national facility

$1,326.02

Hip osteotomy

27147-50 · Bilateral: 150%

$1,989.03

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).

When to use modifier 50

27147 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 27147

    Hip osteotomy21.52 wRVU

    Not priced

  • 27146

    Hip osteotomy18.45 wRVU

    Not priced

  • 27165

    Femoral osteotomy19.78 wRVU

    Not priced

  • 27130

    Hip replacement19.11 wRVU

    Not priced

How to choose

27146Hip osteotomy
27146 describes a pelvic osteotomy alone. Choose 27147 when the surgeon also performs a femoral osteotomy as part of the reconstruction.
27165Femoral osteotomy
27165 describes a femoral osteotomy without the combined pelvic procedure. 27147 is the relevant choice when both pelvic and femoral osteotomies are performed.
27130Hip replacement
27130 is total hip replacement. 27147 is a bone-realignment reconstruction that preserves the native joint rather than replacing it.

Codes related to 27147

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

Codes related to 27147
CodeHow it relatesNational office range
Used instead
27146Hip osteotomyPelvic osteotomy without the femoral osteotomy included in 27147.No office rate
27165Femoral osteotomyFemoral osteotomy for a situation treated without the combined pelvic osteotomy.No office rate
27130Hip replacementTotal hip arthroplasty is a different treatment option for selected hip disease.No office rate

27147 billing questions

When should I choose this instead of 27146?

Use 27147 when the operation includes both a pelvic osteotomy and a femoral osteotomy. Code 27146 describes the pelvic osteotomy without the femoral osteotomy.

Can the femoral osteotomy be billed separately?

The combined procedure is represented by 27147 when the pelvic and femoral osteotomies are performed together as the described reconstruction. The operative report should make both components clear.

What documentation supports reporting this code?

Document the hip deformity or other indication, the pelvic and femoral bones treated, the osteotomies performed, and the side. The operative report should establish that both bony components were part of the reconstruction.

How is bilateral reporting handled?

CMS lists bilateral reporting with modifier 50, paid at 150%. The documentation should support the procedure on both sides.

What postoperative care is included?

The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.

May an assistant or co-surgeon be paid?

Assistant-at-surgery payment may be allowed. Co-surgeon payment requires supporting documentation, and team surgery is not permitted.

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
RVUs for 27147PPRRVU2026_Oct_nonQPP.csv, line 2,767 (RVU26D)

Open CMS sourceHow we calculate rates

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