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Billing code 27158: Pelvic osteotomyMedicare rate & RVUs

Reports bilateral pelvic osteotomy to correct hip alignment, such as for congenital hip dislocation, with open reduction included when performed.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare pays $1,267.56 for 27158 nationally in a facility.

Medicare rate · 27158

Pelvic osteotomy

Swap in your local Medicare rate.

Work RVUs
20.51
Total RVUs
37.95
Global days
090

National rate · 2026

$1,267.56

Facility setting, before claim adjustments.

See every locality for 27158 → · 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.

On this page 10 sections
  1. Medicare rate
  2. What 27158 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 27158 covers

An orthopedic surgeon performs this bilateral pelvic osteotomy to reposition or reshape the pelvis as part of correcting hip alignment, commonly for congenital hip dislocation or developmental hip dysplasia. The operation is performed in the operating room; open reduction of the hip is included when performed as part of the procedure. This code identifies the bilateral pelvic service, rather than a femoral osteotomy or hip replacement.

Select the code from the operative report’s documented procedure and laterality, including the pelvic bone work and whether open reduction was performed. CMS prices this code as bilateral, so modifier 50 does not increase payment. It has a 90-day global period, which includes 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 multiple procedure reduction. Assistant-at-surgery payment may be allowed; co-surgeon and team-surgery payment 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 27158 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

27158 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$1,149.75
Alaska*Unavailable$1,573.10
ArizonaUnavailable$1,233.05
ArkansasUnavailable$1,135.33
AtlantaUnavailable$1,305.88
AustinUnavailable$1,277.67
BakersfieldUnavailable$1,265.58
Baltimore/Surr. CntysUnavailable$1,344.93
BeaumontUnavailable$1,217.91
BrazoriaUnavailable$1,237.07

27158 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.

View every state and territory as a table
27158 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 27158 rate is calculated

Each of 27158’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 · 27158

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 20.51Practice expense 13.08Malpractice 4.36

37.9500 adjusted RVUs×$33.4009 conversion factor=$1,267.56

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 27158

27158 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 27158

Pelvic 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)2Already bilateral by definition: paid once at 100%.
Assistant at surgery (80/81/82/AS)2Paid.
Co-surgeons (62)0Not permitted.
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 · 27158

Pelvic 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.

  • 24 Unrelated E/M visit by the same physician
  • 79 Unrelated procedure (starts its own global period)
  • 58 Staged, more extensive, or therapy procedure that was planned
  • 78 Unplanned 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 51 · payment effect

With and without the modifier

27158 without 51 · national facility

$1,267.56

Pelvic osteotomy

27158-51 · Second procedure: 50%

$633.78

When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).

When to use modifier 51

27158 compared with similar codes

Compare codes

27158 vs 27156 vs 27146 vs 27147: national Medicare rates

Swap in your local Medicare rate.

  • 27158
    Pelvic osteotomy · 20.51 wRVU
    —
  • 27156
    Hip reconstruction · 25.57 wRVU
    —
  • 27146
    Hip osteotomy · 18.45 wRVU
    —
  • 27147
    Hip osteotomy · 21.52 wRVU
    —

How to choose

27156Hip reconstruction
Choose 27158 for bilateral pelvic osteotomy and 27156 for the unilateral counterpart; 27158 is already priced bilaterally.
27146Hip osteotomy
27146 describes a different pelvic bone osteotomy service. Select according to the specific operation documented, rather than using it for bilateral hip-correction osteotomy.
27147Hip osteotomy
27147 represents a different pelvic osteotomy procedure scope. Use 27158 when the documented service is bilateral pelvic osteotomy for hip correction.

Codes related to 27158

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

Codes related to 27158
CodeHow it relatesNational office range
Same family
27156Hip reconstructionUnilateral counterpart for pelvic osteotomy with hip correction.No office rate
Used instead
27146Hip osteotomyPelvic bone osteotomy code for a different operative indication or procedure scope.No office rate
27147Hip osteotomyPelvic osteotomy code whose procedure scope differs from bilateral hip-correction osteotomy.No office rate

27158 billing questions

When should the bilateral code be selected instead of 27156?

Use 27158 when the documented pelvic osteotomy is bilateral. Code 27156 is the unilateral counterpart.

Should modifier 50 be added?

No. CMS prices 27158 as bilateral, and modifier 50 does not increase payment.

Is open reduction separately reported with this procedure?

Open reduction of the hip is included when performed as part of the pelvic osteotomy reported with 27158.

What postoperative care is included?

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

Can an assistant-at-surgery claim be submitted?

Assistant-at-surgery payment may be allowed. Co-surgeon and team-surgery payment are not permitted for this code.

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 27158PPRRVU2026_Oct_nonQPP.csv, line 2,770 (RVU26D)

Open CMS sourceHow we calculate rates

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