No office rate
Both describe percutaneous growth arrest, but 27475 identifies the distal femur and 27477 the proximal tibia.
On this page
CMS RVU26D · Effective 2026-10-01
27477 Growth arrest surgery Medicare reimbursement rates in Connecticut
Percutaneous epiphysiodesis of the proximal tibia is reported when a surgeon arrests growth at that physis to manage a developing limb-length discrepancy. Compare 27477 office and facility rates across CMS payment localities in Connecticut.
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 27477 in Connecticut?
Connecticut 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
$730.82
1 of 1 localities have a supported rate.
Payment area: Connecticut
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 27477: Percutaneous proximal tibial growth arrest
Percutaneous epiphysiodesis of the proximal tibia is reported when a surgeon arrests growth at that physis to manage a developing limb-length discrepancy.
This service is percutaneous epiphysiodesis at the proximal tibial growth plate. A pediatric orthopedic surgeon may perform it to limit growth in the affected tibia as part of a plan to address a predicted limb-length discrepancy. The approach is percutaneous rather than an open exposure; the operative record should identify the treated physis and describe the method used to arrest growth.
Report this code for the proximal tibia, not the distal femur alone or both sites together. Documentation should support the clinical growth-arrest plan, the anatomic site, and the percutaneous approach. 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 is restricted; co-surgeons require supporting documentation, and team surgery is not permitted.
CMS billing rules for 27477
- 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
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU9.89 · 48%
- Practice expense (office) RVU8.59 · 42%
- Malpractice RVU2.10 · 10%
26
Medicare services in 2024 · #5748 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.
27477 compared with similar codes
Office rates for Connecticut, from the same CMS release.
No office rate
27479 covers percutaneous epiphysiodesis at both the distal femur and proximal tibia; 27477 is for the proximal tibia site.
No office rate
27485 describes an open epiphysiodesis approach. Choose 27477 for percutaneous treatment at the proximal tibia.
Compare 27477 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
Connecticut →
Office / nonfacility
Unavailable
Facility
$730.82
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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 27477 in Connecticut.
PPRRVU2026_Oct_nonQPP.csv
2,911
- Code
- 27477
- Physician work
- 9.89
- Practice expense
- 8.59
- Malpractice
- 2.10
GPCI2026.csv
38
- Locality
- Connecticut
- Physician work
- 1.020
- Practice expense
- 1.077
- Malpractice
- 1.210
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 9.89 | × 1.020 | 10.0878 |
| Practice expense | 8.59 | × 1.077 | 9.2514 |
| Malpractice | 2.10 | × 1.210 | 2.5410 |
| Total RVUs | 21.8802 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Connecticut$730.82
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 9.89 | 1.02 |
| Practice expense | 8.59 | 1.077 |
| Malpractice | 2.1 | 1.21 |
(9.89 × 1.02 + 8.59 × 1.077 + 2.1 × 1.21) × $33.4009 = $730.82
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.
27477 billing questions
How does 27477 differ from 27475?
27477 is for percutaneous growth arrest at the proximal tibia. 27475 is for the distal femur.
When is 27479 a better fit?
Use 27479 when the percutaneous epiphysiodesis treats both the distal femur and proximal tibia. 27477 identifies the proximal tibia site alone.
What documentation supports 27477?
The operative record should identify the proximal tibial physis, establish the growth-arrest intent, and describe the percutaneous approach.
How is bilateral treatment reported under the CMS rule?
For a bilateral procedure, report modifier 50; CMS payment for the bilateral procedure is 150%.
Are related postoperative visits included?
Yes. 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 for this procedure?
CMS restricts assistant-at-surgery payment. Co-surgeons are paid only with 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 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.
2,90827470,,Repair of thigh,A,,16.71,12.23,NA,12.23,,3.55,32.49,32.49,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,90927472,,Repair/graft of thigh,A,,18.25,12.48,NA,12.48,,3.88,34.61,34.61,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,91027475,,Surgery to stop leg growth,A,,8.71,8.22,NA,8.22,,1.85,18.78,18.78,0,090,0.10,0.69,0.21,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,91127477,,Surgery to stop leg growth,A,,9.89,8.59,NA,8.59,,2.10,20.58,20.58,0,090,0.10,0.69,0.21,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,91227479,,Surgery to stop leg growth,A,,12.83,9.87,NA,9.87,,2.73,25.43,25.43,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,91327485,,Surgery to stop leg growth,A,,8.90,8.16,NA,8.16,,1.90,18.96,18.96,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,91427486,,Revise/replace knee joint,A,,20.59,13.23,NA,13.23,,4.35,38.17,38.17,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3501112,CA,70,YUBA CITY,1.017,1.096,0.536
3601112,CA,75,REST OF CALIFORNIA,1.017,1.096,0.536
3704112,CO,01,COLORADO,1.012,1.064,0.781
3813102,CT,00,CONNECTICUT,1.020,1.077,1.210
3912202,DC,01,DC + MD/VA SUBURBS,1.054,1.178,1.113
4012102,DE,01,DELAWARE,1.005,0.988,0.899
4109102,FL,03,FORT LAUDERDALE,1.000,1.013,1.808