No office rate
Choose 27178 for open SCFE treatment with corrective osteotomy. Choose 27177 when the open treatment involves proximal femoral epiphysiodesis.
On this page
CMS RVU26D · Effective 2026-10-01
27178 SCFE surgery Medicare reimbursement rates
Reports open operative treatment of slipped capital femoral epiphysis when the surgeon performs a corrective osteotomy, with fixation as indicated. Compare 27178 office and facility rates across CMS payment localities.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 27178?
The service location and office or facility setting determine which base rate applies. These are the supported base rates for the 109 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Where 27178 pays more and less
Orthopedic surgery
About 27178: Slipped epiphysis open treatment with osteotomy
Reports open operative treatment of slipped capital femoral epiphysis when the surgeon performs a corrective osteotomy, with fixation as indicated.
This code is for open surgery to treat slipped capital femoral epiphysis (SCFE) that includes a corrective osteotomy of the proximal femur. The operation is generally performed by an orthopedic surgeon, often for an adolescent whose femoral head has displaced at the growth plate and requires operative correction. The operative report should make clear that treatment included the osteotomy, not just closed reduction or a different open treatment approach.
Report the code when the documented procedure matches that osteotomy-based treatment; include the affected side and describe the correction and any fixation performed. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. For bilateral procedures reported with modifier 50, CMS pays at 150%. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to a 50% reduction. An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 27178
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral procedure with modifier 50 is paid at 150%.
- Assistant at surgery
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU12.60 · 49%
- Practice expense (office) RVU10.37 · 40%
- Malpractice RVU2.68 · 10%
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.
27178 compared with similar codes
Office rate ranges across all CMS payment localities, from the same CMS release.
No office rate
27175 is closed treatment without manipulation. It does not describe the open osteotomy-based operation reported with 27178.
No office rate
27176 is closed treatment with manipulation, with or without skeletal traction. The open corrective osteotomy in 27178 distinguishes that code.
No office rate
27181 describes femoral neck osteotomy for SCFE. Compare the documented operative method and scope with the open treatment represented by 27178.
See how rates vary across the country
27178 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.
Explore a state
Local rates. Clear comparisons.
Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.
View all state and territory rates as a table
| State / territory | Rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
Compare 27178 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | Office Unavailable | Facility $774.59 |
| Alaska* | Office Unavailable | Facility $1049.48 |
| Arizona | Office Unavailable | Facility $833.11 |
| Arkansas | Office Unavailable | Facility $764.48 |
| Atlanta | Office Unavailable | Facility $881.53 |
| Austin | Office Unavailable | Facility $867.46 |
| Bakersfield | Office Unavailable | Facility $862.98 |
| Baltimore/Surr. Cntys | Office Unavailable | Facility $909.97 |
| Beaumont | Office Unavailable | Facility $819.20 |
| Brazoria | Office Unavailable | Facility $837.29 |
| Chicago | Office Unavailable | Facility $977.33 |
| Chico | Office Unavailable | Facility $855.60 |
| Colorado | Office Unavailable | Facility $864.35 |
| Connecticut | Office Unavailable | Facility $910.62 |
| Dallas | Office Unavailable | Facility $846.42 |
| Dc + Md/Va Suburbs | Office Unavailable | Facility $951.23 |
| Delaware | Office Unavailable | Facility $845.64 |
| Detroit | Office Unavailable | Facility $906.02 |
| East St. Louis | Office Unavailable | Facility $919.79 |
| El Centro | Office Unavailable | Facility $856.05 |
| Fort Lauderdale | Office Unavailable | Facility $933.56 |
| Fort Worth | Office Unavailable | Facility $844.12 |
| Fresno | Office Unavailable | Facility $855.60 |
| Galveston | Office Unavailable | Facility $842.28 |
| Hanford-Corcoran | Office Unavailable | Facility $855.60 |
| Hawaii, Guam | Office Unavailable | Facility $866.50 |
| Houston | Office Unavailable | Facility $891.33 |
| Idaho | Office Unavailable | Facility $781.85 |
| Indiana | Office Unavailable | Facility $785.44 |
| Iowa | Office Unavailable | Facility $773.31 |
| Kansas | Office Unavailable | Facility $779.08 |
| Kentucky | Office Unavailable | Facility $810.68 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Office Unavailable | Facility $907.30 |
| Madera | Office Unavailable | Facility $855.60 |
| Manhattan | Office Unavailable | Facility $992.23 |
| Merced | Office Unavailable | Facility $855.60 |
| Metropolitan Boston | Office Unavailable | Facility $931.34 |
| Metropolitan Kansas City | Office Unavailable | Facility $833.55 |
| Metropolitan Philadelphia | Office Unavailable | Facility $895.79 |
| Metropolitan St. Louis | Office Unavailable | Facility $840.29 |
| Miami | Office Unavailable | Facility $1007.80 |
| Minnesota | Office Unavailable | Facility $803.76 |
| Mississippi | Office Unavailable | Facility $785.22 |
| Modesto | Office Unavailable | Facility $855.60 |
| Montana** | Office Unavailable | Facility $856.55 |
| Napa | Office Unavailable | Facility $949.35 |
| Nebraska | Office Unavailable | Facility $774.38 |
| Nevada** | Office Unavailable | Facility $842.13 |
| New Hampshire | Office Unavailable | Facility $859.74 |
| New Mexico | Office Unavailable | Facility $845.98 |
| New Orleans | Office Unavailable | Facility $848.47 |
| North Carolina | Office Unavailable | Facility $801.21 |
| North Dakota** | Office Unavailable | Facility $803.56 |
| Northern Nj | Office Unavailable | Facility $944.75 |
| Nyc Suburbs/Long Island | Office Unavailable | Facility $1025.84 |
| Ohio | Office Unavailable | Facility $827.32 |
| Oklahoma | Office Unavailable | Facility $799.71 |
| Oxnard-Thousand Oaks-Ventura | Office Unavailable | Facility $897.81 |
| Portland | Office Unavailable | Facility $879.00 |
| Poughkpsie/N Nyc Suburbs | Office Unavailable | Facility $927.37 |
| Puerto Rico | Office Unavailable | Facility $859.20 |
| Queens | Office Unavailable | Facility $986.27 |
| Redding | Office Unavailable | Facility $855.60 |
| Rest Of California | Office Unavailable | Facility $855.60 |
| Rest Of Florida | Office Unavailable | Facility $886.52 |
| Rest Of Georgia | Office Unavailable | Facility $836.51 |
| Rest Of Illinois | Office Unavailable | Facility $877.00 |
| Rest Of Louisiana | Office Unavailable | Facility $813.14 |
| Rest Of Maine | Office Unavailable | Facility $795.19 |
| Rest Of Maryland | Office Unavailable | Facility $857.76 |
| Rest Of Massachusetts | Office Unavailable | Facility $863.65 |
| Rest Of Michigan | Office Unavailable | Facility $838.15 |
| Rest Of Missouri | Office Unavailable | Facility $806.61 |
| Rest Of New Jersey | Office Unavailable | Facility $914.12 |
| Rest Of New York | Office Unavailable | Facility $812.83 |
| Rest Of Oregon | Office Unavailable | Facility $828.76 |
| Rest Of Pennsylvania | Office Unavailable | Facility $823.41 |
| Rest Of Texas | Office Unavailable | Facility $830.39 |
| Rest Of Washington | Office Unavailable | Facility $859.17 |
| Rhode Island | Office Unavailable | Facility $866.49 |
| Riverside-San Bernardino-Ontario | Office Unavailable | Facility $884.40 |
| Sacramento-Roseville-Folsom | Office Unavailable | Facility $886.81 |
| Salinas | Office Unavailable | Facility $883.32 |
| San Diego-Chula Vista-Carlsbad | Office Unavailable | Facility $896.25 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Office Unavailable | Facility $990.30 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Office Unavailable | Facility $987.25 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Office Unavailable | Facility $1014.59 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Office Unavailable | Facility $1002.14 |
| San Luis Obispo-Paso Robles | Office Unavailable | Facility $870.50 |
| Santa Cruz-Watsonville | Office Unavailable | Facility $898.51 |
| Santa Maria-Santa Barbara | Office Unavailable | Facility $884.48 |
| Santa Rosa-Petaluma | Office Unavailable | Facility $906.80 |
| Seattle (King Cnty) | Office Unavailable | Facility $940.02 |
| South Carolina | Office Unavailable | Facility $816.98 |
| South Dakota** | Office Unavailable | Facility $797.30 |
| Southern Maine | Office Unavailable | Facility $820.58 |
| Stockton | Office Unavailable | Facility $855.60 |
| Suburban Chicago | Office Unavailable | Facility $938.14 |
| Tennessee | Office Unavailable | Facility $783.77 |
| Utah | Office Unavailable | Facility $826.82 |
| Vallejo | Office Unavailable | Facility $944.96 |
| Vermont | Office Unavailable | Facility $809.05 |
| Virgin Islands | Office Unavailable | Facility $859.20 |
| Virginia | Office Unavailable | Facility $824.53 |
| Visalia | Office Unavailable | Facility $855.60 |
| West Virginia | Office Unavailable | Facility $849.94 |
| Wisconsin | Office Unavailable | Facility $780.24 |
| Wyoming** | Office Unavailable | Facility $833.46 |
| Yuba City | Office Unavailable | Facility $855.60 |
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27178 billing questions
How does this differ from 27177?
27178 describes open SCFE treatment with a corrective osteotomy. 27177 is the open treatment approach involving proximal femoral epiphysiodesis.
When would 27175 or 27176 be more appropriate?
Those codes describe closed treatment: 27175 without manipulation and 27176 with manipulation, with or without skeletal traction. Use 27178 when the documented operation includes open treatment with osteotomy.
Does the code include postoperative visits?
CMS assigns a 90-day global period. The day-before preoperative visit and related postoperative care during the 90 days are included.
Can modifier 50 be used for bilateral treatment?
CMS lists this as a bilateral procedure; with modifier 50, it is paid at 150%. The record should support treatment of both sides.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery services may be paid. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
What documentation supports reporting 27178?
The operative report should identify SCFE and describe the open corrective osteotomy, the side treated, and any fixation performed. The documented procedure must distinguish it from closed treatment or open treatment using another approach.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
2,77427175,,Treat slipped epiphysis,A,,9.15,7.49,NA,7.49,,1.95,18.59,18.59,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,77527176,,Treat slipped epiphysis,A,,12.60,10.37,NA,10.37,,2.68,25.65,25.65,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,77627177,,Treat slipped epiphysis,A,,15.69,11.70,NA,11.70,,3.34,30.73,30.73,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,77727178,,Treat slipped epiphysis,A,,12.60,10.37,NA,10.37,,2.68,25.65,25.65,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,77827179,,Revise head/neck of femur,A,,13.62,10.53,NA,10.53,,2.91,27.06,27.06,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,77927181,,Treat slipped epiphysis,A,,15.78,11.78,NA,11.78,,3.35,30.91,30.91,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,78027185,,Revision of femur epiphysis,A,,9.55,8.68,NA,8.68,,2.04,20.27,20.27,0,090,0.10,0.69,0.21,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00