No office rate
Choose based on the level of the femoral osteotomy: neck for 27161, versus intertrochanteric or subtrochanteric for 27165.
On this page
CMS RVU26D · Effective 2026-10-01
27165 Femoral osteotomy Medicare reimbursement rates in Alabama
Reports a corrective cut through the proximal femur at the intertrochanteric or subtrochanteric level, with fixation or casting included in the service. Compare 27165 office and facility rates across CMS payment localities in Alabama.
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 27165 in Alabama?
Alabama has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$1141.24
1 of 1 localities have a supported rate.
Payment area: Alabama
One mapped payment locality.
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.
Orthopedic surgery
About 27165: Proximal femoral corrective osteotomy
Reports a corrective cut through the proximal femur at the intertrochanteric or subtrochanteric level, with fixation or casting included in the service.
An orthopedic surgeon performs this operation to change alignment or correct a deformity of the proximal femur by cutting bone at the intertrochanteric or subtrochanteric level. Internal or external fixation and casting, when used as part of the osteotomy, are included. The service is generally performed in an operating room, often for a femoral deformity or malalignment requiring correction at one of these levels.
Select the code based on the osteotomy’s documented location and operative work, rather than the diagnosis alone. The operative report should identify the level and purpose of the bone cut and describe the correction and fixation or cast used. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures 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.
CMS billing rules for 27165
- 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 RVU19.78 · 52%
- Practice expense (office) RVU13.72 · 36%
- Malpractice RVU4.21 · 11%
122
Medicare services in 2024 · #4727 by national volume
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.
27165 compared with similar codes
Office rates for Alabama, from the same CMS release.
No office rate
27178 describes open treatment of slipped upper femoral epiphysis with an osteotomy. Use 27165 for the intertrochanteric or subtrochanteric osteotomy when the specific slipped-epiphysis service is not being performed.
No office rate
27146 is an osteotomy of the pelvis; 27165 is for a corrective osteotomy of the proximal femur.
Compare 27165 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.
1 of 1 payment localities
Alabama →
Office / nonfacility
Unavailable
Facility
$1141.24
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 27165 in Alabama.
PPRRVU2026_Oct_nonQPP.csv
2,772
- Code
- 27165
- Physician work
- 19.78
- Practice expense
- 13.72
- Malpractice
- 4.21
GPCI2026.csv
4
- Locality
- Alabama
- Physician work
- 1.000
- Practice expense
- 0.875
- Malpractice
- 0.566
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 19.78 | × 1.000 | 19.7800 |
| Practice expense | 13.72 | × 0.875 | 12.0050 |
| Malpractice | 4.21 | × 0.566 | 2.3829 |
| Total RVUs | 34.1679 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Alabama$1141.24
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 19.78 | 1 |
| Practice expense | 13.72 | 0.875 |
| Malpractice | 4.21 | 0.566 |
(19.78 × 1 + 13.72 × 0.875 + 4.21 × 0.566) × $33.4009 = $1141.24
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
27165 billing questions
How does this differ from code 27161?
The osteotomy level distinguishes them: 27165 is for the intertrochanteric or subtrochanteric femur, while 27161 applies to the femoral neck.
Are fixation and casting separately reported?
Fixation or casting used as part of this osteotomy is included in the service. The operative report should describe the method used.
What documentation supports code 27165?
Document the osteotomy’s intertrochanteric or subtrochanteric location, the reason for correcting alignment, and the bone work and fixation or casting performed.
How is bilateral surgery reported?
For bilateral procedures, report modifier 50; CMS pays the bilateral service 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.
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.
2,76927156,,Revision of hip bones,A,,25.57,14.89,NA,14.89,,5.45,45.91,45.91,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,77027158,,Revision of pelvis,A,,20.51,13.08,NA,13.08,,4.36,37.95,37.95,0,090,0.10,0.69,0.21,2,2,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,77127161,,Incision of neck of femur,A,,17.44,12.25,NA,12.25,,3.71,33.40,33.40,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,77227165,,Incision/fixation of femur,A,,19.78,13.72,NA,13.72,,4.21,37.71,37.71,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,77327170,,Repair/graft femur head/neck,A,,17.17,11.07,NA,11.07,,3.65,31.89,31.89,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,77427175,,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
1ADDENDUM E. FINAL CY 2026 GEOGRAPHIC PRACTICE COST INDICES (GPCIs) BY STATE AND MEDICARE LOCALITY,,,,,,
2,,,,,,
3Medicare Administrative Contractor (MAC),State,Locality Number,Locality Name,2026 PW GPCI (with 1.0 Floor)***,2026 PE GPCI,2026 MP GPCI
410112,AL,00,ALABAMA,1.000,0.875,0.566
502102,AK,01,ALASKA*,1.500,1.065,0.551
603102,AZ,00,ARIZONA,1.000,0.969,0.856
707102,AR,13,ARKANSAS,1.000,0.859,0.515