FeeBase
Log inGet started
Menu

Billing code 27457: Knee realignmentMedicare rate & RVUs

Proximal tibial osteotomy to correct knee alignment in patients older than six, with associated fibular osteotomy when performed.

CMS RVU26DEffective Oct 1, 2026109 payment localities1.5K Medicare services in 2024

Medicare pays $880.11 for 27457 nationally in a facility.

Medicare rate · 27457

Knee realignment

Swap in your local Medicare rate.

Work RVUs
13.68
Total RVUs
26.35
Global days
090

National rate · 2026

$880.11

Facility setting, before claim adjustments.

See every locality for 27457 → · 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 27457 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 27457 covers

An orthopedic surgeon uses this operation to correct a knee-axis deformity by cutting and repositioning the proximal tibia; an associated fibular osteotomy may also be performed. Typical indications include genu varum or genu valgum when the deformity is being corrected at the proximal tibia. The age distinction separates this code from the related proximal tibial osteotomy code for younger patients. The procedure is generally performed in an operating room, with the operative report identifying the deformity, the bone corrected, and any fibular work.

Report this code for the older-than-six age category, rather than 27455, which represents the younger age category. Documentation should support the patient’s age, the alignment problem, and the proximal tibial correction performed. CMS assigns a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and the others at 50%. 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 27457 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

27457 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$797.18
Alaska*Unavailable$1,086.12
ArizonaUnavailable$856.01
ArkansasUnavailable$787.01
AtlantaUnavailable$906.24
AustinUnavailable$888.85
BakersfieldUnavailable$882.09
Baltimore/Surr. CntysUnavailable$934.26
BeaumontUnavailable$843.87
BrazoriaUnavailable$859.45

27457 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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 every state and territory as a table
27457 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 27457 rate is calculated

Each of 27457’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 · 27457

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 13.68Practice expense 9.76Malpractice 2.91

26.3500 adjusted RVUs×$33.4009 conversion factor=$880.11

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

Payment rules and modifiers for 27457

27457 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 27457

Knee realignment

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 · 27457

Knee realignment

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

27457 without 50 · national facility

$880.11

Knee realignment

27457-50 · Bilateral: 150%

$1,320.17

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

27457 compared with similar codes

Compare codes

27457 vs 27455 vs 27454 vs 27447: national Medicare rates

Swap in your local Medicare rate.

  • 27457
    Knee realignment · 13.68 wRVU
    —
  • 27455
    Knee realignment · 13.03 wRVU
    —
  • 27454
    Femoral osteotomy · 18.69 wRVU
    —
  • 27447
    Total knee replacement · 19.11 wRVU
    —

How to choose

27455Knee realignment
This is the same proximal tibial osteotomy family, but 27455 represents the younger age category; 27457 is for patients older than six.
27454Femoral osteotomy
Use the femoral realignment code when the correction is performed on the thigh bone. Code 27457 concerns correction at the proximal tibia.
27447Total knee replacement
27447 describes total knee replacement. It is not the code for correcting knee alignment through a proximal tibial osteotomy.

Codes related to 27457

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

Codes related to 27457
CodeHow it relatesNational office range
Same family
27455Knee realignmentProximal tibial osteotomy in the younger patient age category.No office rate
Used instead
27454Femoral osteotomyConsider when the alignment correction is performed at the femur rather than the proximal tibia.No office rate
27447Total knee replacementTotal knee replacement is a different operative approach for knee disease, not a tibial realignment osteotomy.No office rate

27457 billing questions

How is 27457 distinguished from 27455?

The age category distinguishes the two proximal tibial osteotomy codes: 27457 is for patients older than six, while 27455 is for the younger category. Document the patient’s age and the proximal tibial correction.

What should the operative report document?

Document the knee alignment deformity, the proximal tibial osteotomy and realignment performed, the patient’s age, and any associated fibular osteotomy.

Are related postoperative visits included?

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

How are other procedures in the same session paid?

Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50%.

Can 27457 be reported for both knees?

For bilateral reporting with modifier 50, CMS pays 150% under the stated bilateral rule.

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 27457PPRRVU2026_Oct_nonQPP.csv, line 2,904 (RVU26D)

Open CMS sourceHow we calculate rates

Did this answer your question about what 27457 pays?

Tell us what you were actually trying to work out. We’ll answer you directly, or build the page that does.

Fee sheets

Put 27457 and the rest of your codes on one sheet

Build a fee sheet from your own code list at your locality, put your payer contracts beside Medicare, and see what changed each quarter.

Build my fee sheetOr price your code list free →