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Billing code 27450: Femoral osteotomyMedicare rate & RVUs

Reports a femoral shaft or supracondylar osteotomy performed without internal fixation to correct bone alignment or deformity.

CMS RVU26DEffective Oct 1, 2026109 payment localities139 Medicare services in 2024

Medicare pays $928.55 for 27450 nationally in a facility.

Medicare rate · 27450

Femoral osteotomy

Swap in your local Medicare rate.

Work RVUs
14.24
Total RVUs
27.80
Global days
090

National rate · 2026

$928.55

Facility setting, before claim adjustments.

See every locality for 27450 → · 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 27450 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 27450 covers

This service is an osteotomy of the femoral shaft or supracondylar region performed without internal fixation. An orthopedic surgeon may use it to change the alignment of the thigh bone, such as when correcting a deformity. The procedure is typically performed in an operating room; the operative report should identify the femoral site and describe the bone cut and correction made.

Select this code when the documented osteotomy is in the specified femoral region and is performed without internal fixation. The operative note should support the site, technique, and absence of internal fixation, distinguishing this service from the related code for an osteotomy with fixation. CMS assigns 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 the others are subject to the standard multiple procedure reduction. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be made; 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 27450 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

27450 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$841.69
Alaska*Unavailable$1,145.50
ArizonaUnavailable$903.45
ArkansasUnavailable$831.02
AtlantaUnavailable$955.32
AustinUnavailable$938.93
BakersfieldUnavailable$933.40
Baltimore/Surr. CntysUnavailable$985.27
BeaumontUnavailable$889.64
BrazoriaUnavailable$907.62

27450 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
27450 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 27450 rate is calculated

Each of 27450’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 · 27450

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 14.24Practice expense 10.63Malpractice 2.93

27.8000 adjusted RVUs×$33.4009 conversion factor=$928.55

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

Payment rules and modifiers for 27450

27450 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 27450

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 · 27450

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

27450 without 50 · national facility

$928.55

Femoral osteotomy

27450-50 · Bilateral: 150%

$1,392.83

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

27450 compared with similar codes

Compare codes

27450 vs 27448 vs 27455 vs 27465: national Medicare rates

Swap in your local Medicare rate.

  • 27450
    Femoral osteotomy · 14.24 wRVU
    —
  • 27448
    Femoral osteotomy · 11.31 wRVU
    —
  • 27455
    Knee realignment · 13.03 wRVU
    —
  • 27465
    Femur shortening · 20.6 wRVU
    —

How to choose

27448Femoral osteotomy
Both address a femoral osteotomy in the shaft or supracondylar region. Use 27450 when internal fixation is not used; use 27448 when it is.
27455Knee realignment
This code concerns an osteotomy for a knee-region correction rather than the femoral shaft or supracondylar osteotomy reported with 27450.
27465Femur shortening
Use 27465 when the documented femoral procedure is specifically for shortening; 27450 reports the specified femoral osteotomy without internal fixation.

Codes related to 27450

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

Codes related to 27450
CodeHow it relatesNational office range
Same family
27448Femoral osteotomyRelated femoral osteotomy code when internal fixation is used.No office rate
Used instead
27455Knee realignmentConsider for a corrective osteotomy involving the knee-region bone rather than the femur.No office rate
27457Knee realignmentA knee-region realignment option when the documented correction is not a femoral osteotomy.No office rate
27465Femur shorteningFor a femoral procedure whose documented purpose is shortening.No office rate
27466Femur lengtheningFor a femoral procedure whose documented purpose is lengthening.No office rate

27450 billing questions

How does this differ from 27448?

The key distinction is fixation: 27450 describes the femoral osteotomy without internal fixation, while 27448 is the related code when internal fixation is used. Check the operative report for the fixation method.

What documentation supports reporting this code?

The operative report should identify the femoral shaft or supracondylar site, describe the osteotomy and correction, and establish that internal fixation was not used.

How is a bilateral procedure paid?

CMS lists this as a bilateral procedure; reporting modifier 50 results in payment at 150%.

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 or co-surgeon be paid?

Assistant-at-surgery payment may be made. 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 27450PPRRVU2026_Oct_nonQPP.csv, line 2,901 (RVU26D)

Open CMS sourceHow we calculate rates

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