Billing code 27165: Femoral osteotomyMedicare rate & RVUs in Guam
Reports a corrective cut through the proximal femur at the intertrochanteric or subtrochanteric level, with fixation or casting included in the service.
CMS doesn’t publish an office rate for 27165 in Guam.
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 27165 covers
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.
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 in Hawaii, Guam
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam | Unavailable | $1,263.13 |
How the 27165 rate is calculated
Each of 27165’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 · 27165
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 19.78Practice expense 13.72Malpractice 4.21
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 27165
27165 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 27165
Femoral osteotomy
| 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 · 27165
Femoral osteotomy
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
27165 without 50 · national facility
$1,259.55
Femoral osteotomy
27165-50 · Bilateral: 150%
$1,889.33
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).
27165 compared with similar codes
Compare codes
27165 vs 27161 vs 27178 vs 27146: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 27161Femoral osteotomy
- Choose based on the level of the femoral osteotomy: neck for 27161, versus intertrochanteric or subtrochanteric for 27165.
- 27178SCFE surgery
- 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.
- 27146Hip osteotomy
- 27146 is an osteotomy of the pelvis; 27165 is for a corrective osteotomy of the proximal femur.
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 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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