No office rate
Use 27175 for closed treatment without manipulation; 27177 is open treatment of an acute slip.
On this page
CMS RVU26D · Effective 2026-10-01
27177 Slipped epiphysis Medicare reimbursement rates in Guam
Report this code for open operative treatment of an acute slipped femoral epiphysis, with or without internal fixation. Compare 27177 office and facility rates across CMS payment localities in Guam.
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 27177 in Guam?
Guam 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
$1032.98
1 of 1 localities have a supported rate.
Payment area: Hawaii, Guam
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 27177: Open treatment of acute slipped femoral epiphysis
Report this code for open operative treatment of an acute slipped femoral epiphysis, with or without internal fixation.
An orthopedic surgeon reports this service for open treatment of an acute slipped capital femoral epiphysis (SCFE), a displacement at the growing end of the femur near the hip. The operation addresses the acute slip through an open approach; internal fixation may be used. This is distinct from closed treatment and from open treatment of a chronic slip.
Select the code based on the documented acute condition and open operative approach, not simply the presence of a hip pin or the diagnosis of SCFE. The operative report should establish the acute slip and describe the open treatment and any fixation. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 identifies bilateral treatment and is paid at 150%. Assistant-at-surgery payment may be available; co-surgeons are paid only with supporting documentation. Team surgery is not permitted.
CMS billing rules for 27177
- 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 RVU15.69 · 51%
- Practice expense (office) RVU11.70 · 38%
- Malpractice RVU3.34 · 11%
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.
27177 compared with similar codes
Office rates for Guam, from the same CMS release.
No office rate
Use 27176 for closed treatment with manipulation. An open operative approach for an acute slip is reported with 27177.
No office rate
The key distinction is acuity: 27178 is for open treatment of a chronic slipped femoral epiphysis, while 27177 is for an acute slip.
Compare 27177 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
Hawaii, Guam →
Office / nonfacility
Unavailable
Facility
$1032.98
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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 27177 in Hawaii, Guam.
PPRRVU2026_Oct_nonQPP.csv
2,776
- Code
- 27177
- Physician work
- 15.69
- Practice expense
- 11.70
- Malpractice
- 3.34
GPCI2026.csv
46
- Locality
- Hawaii, Guam
- Physician work
- 1.000
- Practice expense
- 1.137
- Malpractice
- 0.579
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 15.69 | × 1.000 | 15.6900 |
| Practice expense | 11.70 | × 1.137 | 13.3029 |
| Malpractice | 3.34 | × 0.579 | 1.9339 |
| Total RVUs | 30.9268 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Hawaii, Guam$1032.98
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 15.69 | 1 |
| Practice expense | 11.7 | 1.137 |
| Malpractice | 3.34 | 0.579 |
(15.69 × 1 + 11.7 × 1.137 + 3.34 × 0.579) × $33.4009 = $1032.98
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.
27177 billing questions
How does 27177 differ from closed treatment codes 27175 and 27176?
27177 is for open treatment of an acute slipped femoral epiphysis. Codes 27175 and 27176 describe closed treatment, distinguished by whether manipulation is performed.
When should 27177 be distinguished from 27178?
Use 27177 for an acute slip treated through an open approach. Code 27178 is the related open-treatment code for a chronic slipped femoral epiphysis.
Does internal fixation change the code selection?
No. The code includes open treatment with or without internal fixation; document the operative approach and treatment of the acute slip.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How is bilateral treatment reported?
Report modifier 50 for bilateral treatment. CMS pays the bilateral procedure at 150%.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be available. Co-surgeon payment requires 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.
2,77327170,,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
2,77627177,,Treat slipped epiphysis,A,,15.69,11.70,NA,11.70,,3.34,30.73,30.73,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,77727178,,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
2,77827179,,Revise head/neck of femur,A,,13.62,10.53,NA,10.53,,2.91,27.06,27.06,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,77927181,,Treat slipped epiphysis,A,,15.78,11.78,NA,11.78,,3.35,30.91,30.91,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503
4410212,GA,01,ATLANTA,1.003,1.016,1.201
4510212,GA,99,REST OF GEORGIA,1.000,0.892,1.192
4601212,HI,01,"HAWAII, GUAM",1.000,1.137,0.579
4702202,ID,00,IDAHO,1.000,0.920,0.473
4806102,IL,16,CHICAGO,1.007,1.005,2.295
4906102,IL,12,EAST ST. LOUIS,1.000,0.920,2.014