Billing code 27457: Knee realignmentMedicare rate & RVUs in Delaware
Proximal tibial osteotomy to correct knee alignment in patients older than six, with associated fibular osteotomy when performed.
CMS doesn’t publish an office rate for 27457 in Delaware.
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 9 sections
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.
27457 in Delaware
| Payment locality | Office | Facility |
|---|---|---|
| Delaware | Unavailable | $868.67 |
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
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
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.69/0.21 | Share 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.
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).
27457 compared with similar codes
Compare codes
27457 vs 27455 vs 27454 vs 27447: national Medicare rates
Swap in your local Medicare rate.
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.
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
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