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Billing code 27161: Femoral osteotomyMedicare rate & RVUs

Reports a corrective bone cut through the femoral neck, typically performed by an orthopedic surgeon to address a proximal femur deformity.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare pays $1,115.59 for 27161 nationally in a facility.

Medicare rate · 27161

Femoral osteotomy

Swap in your local Medicare rate.

Work RVUs
17.44
Total RVUs
33.40
Global days
090

National rate · 2026

$1,115.59

Facility setting, before claim adjustments.

See every locality for 27161 → · 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 27161 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 27161 covers

The surgeon cuts through the femoral neck to change its alignment or shape, most often to correct a congenital or acquired deformity of the proximal femur. An orthopedic surgeon typically performs the operation in a hospital or ambulatory surgical setting. The operative report should make clear that the cut was at the femoral neck, rather than at the intertrochanteric or subtrochanteric femur, and describe the condition and intended correction.

Report 27161 when the documented work is an osteotomy at the femoral neck; the anatomic level and indication help distinguish it from other hip-region procedures. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others at 50%. For bilateral surgery reported with modifier 50, CMS pays at 150%. Assistant-at-surgery services 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 27161 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

27161 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$1,010.66
Alaska*Unavailable$1,377.80
ArizonaUnavailable$1,085.06
ArkansasUnavailable$997.80
AtlantaUnavailable$1,148.79
AustinUnavailable$1,126.36
BakersfieldUnavailable$1,117.49
Baltimore/Surr. CntysUnavailable$1,184.15
BeaumontUnavailable$1,069.97
BrazoriaUnavailable$1,089.31

27161 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
27161 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 27161 rate is calculated

Each of 27161’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 · 27161

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 17.44Practice expense 12.25Malpractice 3.71

33.4000 adjusted RVUs×$33.4009 conversion factor=$1,115.59

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

Payment rules and modifiers for 27161

27161 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 27161

Femoral 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 · 27161

Femoral 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 50 · payment effect

With and without the modifier

27161 without 50 · national facility

$1,115.59

Femoral osteotomy

27161-50 · Bilateral: 150%

$1,673.39

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

27161 compared with similar codes

Compare codes

27161 vs 27165 vs 27179 vs 27170 vs 27177: national Medicare rates

Swap in your local Medicare rate.

  • 27161
    Femoral osteotomy · 17.44 wRVU
    —
  • 27165
    Femoral osteotomy · 19.78 wRVU
    —
  • 27179
    Femoral osteotomy · 13.62 wRVU
    —
  • 27170
    Femur repair · 17.17 wRVU
    —
  • 27177
    Slipped epiphysis · 15.69 wRVU
    —

How to choose

27165Femoral osteotomy
27161 identifies an osteotomy at the femoral neck. Choose 27165 when the cut is intertrochanteric or subtrochanteric.
27179Femoral osteotomy
27179 is specific to osteotomy for slipped capital femoral epiphysis. Use 27161 for a femoral neck osteotomy when that SCFE-specific service is not the documented procedure.
27170Femur repair
27170 describes bone grafting of the femoral head or neck. It is not the code for a corrective osteotomy.
27177Slipped epiphysis
27177 describes open treatment of slipped femoral epiphysis. Select it when that treatment is documented, rather than coding a femoral neck osteotomy based only on the general anatomic area.

Codes related to 27161

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

Codes related to 27161
CodeHow it relatesNational office range
Used instead
27165Femoral osteotomyUse when the osteotomy is at the intertrochanteric or subtrochanteric femur instead.No office rate
27175Slipped epiphysis treatmentClosed treatment for slipped femoral epiphysis, rather than a femoral neck osteotomy.No office rate
27177Slipped epiphysisOpen treatment for slipped femoral epiphysis; select based on the documented procedure.No office rate
27179Femoral osteotomyOsteotomy associated with slipped capital femoral epiphysis.No office rate

27161 billing questions

How is 27161 distinguished from an osteotomy at another part of the femur?

The operative report must identify the femoral neck as the site of the bone cut. An intertrochanteric or subtrochanteric osteotomy is a different service.

How does 27161 differ from the slipped femoral epiphysis codes?

Use the code that matches the documented treatment of the slipped epiphysis, such as closed or open treatment. Code 27161 describes an osteotomy at the femoral neck, while 27179 is the osteotomy code associated with slipped capital femoral epiphysis.

What documentation supports reporting 27161?

Document the femoral neck as the osteotomy site, the condition prompting surgery, and the corrective work performed. Include laterality and the operative details needed to show the extent of the procedure.

What postoperative care is included in the CMS global period?

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

How are bilateral procedures and additional same-session procedures handled?

CMS pays bilateral surgery reported with modifier 50 at 150%. For multiple procedures in one session, the highest-valued procedure is paid in full and the others at 50%.

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 27161PPRRVU2026_Oct_nonQPP.csv, line 2,771 (RVU26D)

Open CMS sourceHow we calculate rates

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