No office rate
Use 27705 when the osteotomy is limited to the tibia. Report 27709 when the operation includes osteotomy of both the tibia and fibula.
On this page
CMS RVU26D · Effective 2026-10-01
27709 Osteotomy Medicare reimbursement rates in California
Surgical realignment by cutting both lower-leg bones is reported when correction requires osteotomy of the tibia and fibula during one operative session. Compare 27709 office and facility rates across CMS payment localities in California.
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 27709 in California?
California has 29 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 29 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$1044.04–$1224.79
29 of 29 localities have a supported rate.
Lowest: Chico
Highest: San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
A spread of $180.75 per service.
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 27709 pays more and less in California
Orthopedic surgery
About 27709: Tibial and fibular corrective osteotomy
Surgical realignment by cutting both lower-leg bones is reported when correction requires osteotomy of the tibia and fibula during one operative session.
An osteotomy cuts and reshapes bone to change alignment. CPT 27709 is for operative correction involving both the tibia and fibula in the same lower leg, rather than an osteotomy limited to one bone. Orthopedic surgeons may use it to correct a structural deformity or malalignment when correcting both bones is part of the planned reconstruction. The service is generally performed in an operating room; fixation may be used as part of the surgeon’s technique.
Report the code when the operative record supports osteotomy of each bone. Documentation should identify the side, the reason for correction, and the work performed on the tibia and fibula. This major surgery code has a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When other procedures are performed in the same session, the highest-valued procedure is paid in full and additional procedures are subject to the standard 50% reduction. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 27709
- 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 RVU17.04 · 54%
- Practice expense (office) RVU11.06 · 35%
- Malpractice RVU3.37 · 11%
200
Medicare services in 2024 · #4328 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.
27709 compared with similar codes
Office rates for California, from the same CMS release.
No office rate
Use 27707 when the osteotomy is limited to the fibula. Report 27709 when both lower-leg bones are osteotomized.
No office rate
27712 describes tibial realignment on an intramedullary rod. Choose based on the procedure performed, rather than using it for a general osteotomy of both bones.
No office rate
27715 is for tibial and fibular lengthening or shortening. 27709 represents osteotomy of both bones for correction when that lengthening-or-shortening service is not the procedure performed.
Compare 27709 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.
29 of 29 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Bakersfield | Office Unavailable | Facility $1053.39 |
| Chico | Office Unavailable | Facility $1044.04 |
| El Centro | Office Unavailable | Facility $1044.60 |
| Fresno | Office Unavailable | Facility $1044.04 |
| Hanford-Corcoran | Office Unavailable | Facility $1044.04 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Office Unavailable | Facility $1104.24 |
| Madera | Office Unavailable | Facility $1044.04 |
| Merced | Office Unavailable | Facility $1044.04 |
| Modesto | Office Unavailable | Facility $1044.04 |
| Napa | Office Unavailable | Facility $1149.08 |
| Oxnard-Thousand Oaks-Ventura | Office Unavailable | Facility $1091.86 |
| Redding | Office Unavailable | Facility $1044.04 |
| Rest Of California | Office Unavailable | Facility $1044.04 |
| Riverside-San Bernardino-Ontario | Office Unavailable | Facility $1080.29 |
| Sacramento-Roseville-Folsom | Office Unavailable | Facility $1079.60 |
| Salinas | Office Unavailable | Facility $1075.28 |
| San Diego-Chula Vista-Carlsbad | Office Unavailable | Facility $1089.05 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Office Unavailable | Facility $1195.76 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Office Unavailable | Facility $1191.93 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Office Unavailable | Facility $1224.79 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Office Unavailable | Facility $1209.14 |
| San Luis Obispo-Paso Robles | Office Unavailable | Facility $1059.92 |
| Santa Cruz-Watsonville | Office Unavailable | Facility $1090.27 |
| Santa Maria-Santa Barbara | Office Unavailable | Facility $1076.16 |
| Santa Rosa-Petaluma | Office Unavailable | Facility $1100.20 |
| Stockton | Office Unavailable | Facility $1044.04 |
| Vallejo | Office Unavailable | Facility $1143.56 |
| Visalia | Office Unavailable | Facility $1044.04 |
| Yuba City | Office Unavailable | Facility $1044.04 |
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27709 billing questions
When should I report 27709 instead of 27705 or 27707?
Report 27709 when the operative service includes an osteotomy of both the tibia and fibula in the same lower leg. Use 27705 for tibial osteotomy alone or 27707 for fibular osteotomy alone.
Does the code include osteotomy of both bones on both legs?
The code describes work on the tibia and fibula of a lower leg. For bilateral procedures, CMS payment uses modifier 50 and is 150%; the record should support the work on each side.
What documentation supports reporting 27709?
Document the indication and side, and describe the osteotomy performed on each bone and the intended correction. The record should make clear why both bones required operative correction.
How does the 90-day global period affect follow-up visits?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period. Routine follow-up care related to the osteotomy falls within that period.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full, and other procedures in the same session are subject to the standard multiple procedure reduction, with payment at 50%.
Can an assistant or co-surgeon be paid for this operation?
Assistant-at-surgery payment may be available. 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.
3,01727704,,Removal of ankle implant,A,,7.61,6.93,NA,6.93,,1.31,15.85,15.85,0,090,0.10,0.69,0.21,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,01827705,,Osteotomy tibia,A,,10.59,8.19,NA,8.19,,1.96,20.74,20.74,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,01927707,,Osteotomy fibula,A,,4.66,6.20,NA,6.20,,0.89,11.75,11.75,0,090,0.10,0.69,0.21,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,02027709,,Osteotomy tibia & fibula,A,,17.04,11.06,NA,11.06,,3.37,31.47,31.47,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,02127712,,Osteot mlt relignmt imed rod,A,,15.47,11.68,NA,11.68,,3.29,30.44,30.44,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,02227713,,Osteot tibia imed lngth dev,A,,28.00,19.31,NA,19.31,,5.20,52.51,52.51,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,02327715,,Ostpl tibfib lngth/shrt,A,,21.94,14.16,NA,14.16,,4.68,40.78,40.78,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00