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Billing code 27448: Femoral osteotomyMedicare rate & RVUs

Corrects femoral alignment by surgically cutting the shaft or lower femur without internal fixation, typically for a deformity requiring bony realignment.

CMS RVU26DEffective Oct 1, 2026109 payment localities152 Medicare services in 2024

Medicare pays $762.54 for 27448 nationally in a facility.

Medicare rate · 27448

Femoral osteotomy

Swap in your local Medicare rate.

Work RVUs
11.31
Total RVUs
22.83
Global days
090

National rate · 2026

$762.54

Facility setting, before claim adjustments.

See every locality for 27448 → · 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 27448 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 27448 covers

An orthopedic surgeon cuts and repositions the femur at the shaft or near its lower end to correct a bony alignment problem. The procedure may be considered for a femoral deformity that affects limb alignment or knee mechanics. It is performed in an operating room, commonly in a hospital facility, and is distinct from a femoral osteotomy that uses internal fixation or is performed for lengthening with a specified device.

Report this code when the operative record supports an osteotomy at the femoral shaft or supracondylar region and documents that internal fixation was not used. The record should identify the bone and site, the alignment problem, the correction performed, and the fixation approach. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. In a same-session multiple-procedure claim, the highest-valued procedure is paid in full and other procedures at 50%. Bilateral reporting with modifier 50 is paid at 150%. An assistant 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 27448 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

27448 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$689.57
Alaska*Unavailable$935.06
ArizonaUnavailable$741.52
ArkansasUnavailable$680.60
AtlantaUnavailable$784.72
AustinUnavailable$771.77
BakersfieldUnavailable$767.46
Baltimore/Surr. CntysUnavailable$809.88
BeaumontUnavailable$729.44
BrazoriaUnavailable$745.12

27448 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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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
27448 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 27448 rate is calculated

Each of 27448’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 · 27448

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 11.31Practice expense 9.11Malpractice 2.41

22.8300 adjusted RVUs×$33.4009 conversion factor=$762.54

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

Payment rules and modifiers for 27448

27448 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 27448

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 · 27448

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

27448 without 50 · national facility

$762.54

Femoral osteotomy

27448-50 · Bilateral: 150%

$1,143.81

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

27448 compared with similar codes

Compare codes

27448 vs 27450 vs 27455 vs 27458: national Medicare rates

Swap in your local Medicare rate.

  • 27448
    Femoral osteotomy · 11.31 wRVU
    —
  • 27450
    Femoral osteotomy · 14.24 wRVU
    —
  • 27455
    Knee realignment · 13.03 wRVU
    —
  • 27458
    Femoral lengthening · 26.65 wRVU
    —

How to choose

27450Femoral osteotomy
This code is for a femoral shaft or supracondylar osteotomy without internal fixation. Use 27450 when internal fixation is used.
27455Knee realignment
27455 concerns realignment at the knee; 27448 is selected for an osteotomy of the femoral shaft or lower femur.
27458Femoral lengthening
27458 is associated with femoral osteotomy using an intramedullary lengthening device; 27448 describes the osteotomy without internal fixation.

Codes related to 27448

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

Codes related to 27448
CodeHow it relatesNational office range
Same family
27450Femoral osteotomyFemoral shaft or supracondylar osteotomy counterpart when internal fixation is used.No office rate
27458Femoral lengtheningFemoral osteotomy involving an intramedullary lengthening device.No office rate
Used instead
27455Knee realignmentA knee realignment option when the corrective osteotomy is performed at the tibia rather than the femur.No office rate

27448 billing questions

How does this differ from 27450?

Both describe a femoral shaft or supracondylar osteotomy. Use 27448 when internal fixation is not used; 27450 is the fixation counterpart.

What documentation supports reporting 27448?

Document the femoral osteotomy site, the alignment problem and correction, and that internal fixation was not used.

Can the preoperative visit and follow-up be billed separately?

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

How is a bilateral procedure reported?

CMS identifies this as a bilateral procedure; modifier 50 is paid at 150%.

Can an assistant or co-surgeon be reported?

An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation; team surgery is not permitted.

What happens when another procedure is performed in the same session?

Under the standard multiple-procedure reduction, the highest-valued procedure is paid in full and the other procedures 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 27448PPRRVU2026_Oct_nonQPP.csv, line 2,900 (RVU26D)

Open CMS sourceHow we calculate rates

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