No office rate
This is the same proximal tibial osteotomy family, but 27455 represents the younger age category; 27457 is for patients older than six.
On this page
CMS RVU26D · Effective 2026-10-01
27457 Knee realignment Medicare reimbursement rates in Indiana
Proximal tibial osteotomy to correct knee alignment in patients older than six, with associated fibular osteotomy when performed. Compare 27457 office and facility rates across CMS payment localities in Indiana.
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 27457 in Indiana?
Indiana 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
$806.36
1 of 1 localities have a supported rate.
Payment area: Indiana
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 27457: Proximal tibial realignment osteotomy
Proximal tibial osteotomy to correct knee alignment in patients older than six, with associated fibular osteotomy when performed.
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.
CMS billing rules for 27457
- 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 RVU13.68 · 52%
- Practice expense (office) RVU9.76 · 37%
- Malpractice RVU2.91 · 11%
1.5K
Medicare services in 2024 · #2680 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.
27457 compared with similar codes
Office rates for Indiana, from the same CMS release.
No office rate
Use the femoral realignment code when the correction is performed on the thigh bone. Code 27457 concerns correction at the proximal tibia.
No office rate
27447 describes total knee replacement. It is not the code for correcting knee alignment through a proximal tibial osteotomy.
Compare 27457 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
Indiana →
Office / nonfacility
Unavailable
Facility
$806.36
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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 27457 in Indiana.
PPRRVU2026_Oct_nonQPP.csv
2,904
- Code
- 27457
- Physician work
- 13.68
- Practice expense
- 9.76
- Malpractice
- 2.91
GPCI2026.csv
52
- Locality
- Indiana
- Physician work
- 1.000
- Practice expense
- 0.927
- Malpractice
- 0.486
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 13.68 | × 1.000 | 13.6800 |
| Practice expense | 9.76 | × 0.927 | 9.0475 |
| Malpractice | 2.91 | × 0.486 | 1.4143 |
| Total RVUs | 24.1418 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Indiana$806.36
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 13.68 | 1 |
| Practice expense | 9.76 | 0.927 |
| Malpractice | 2.91 | 0.486 |
(13.68 × 1 + 9.76 × 0.927 + 2.91 × 0.486) × $33.4009 = $806.36
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.
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 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.
2,90127450,,Incision of thigh,A,,14.24,10.63,NA,10.63,,2.93,27.80,27.80,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,90227454,,Realignment of thigh bone,A,,18.69,12.70,NA,12.70,,3.98,35.37,35.37,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,90327455,,Realignment of knee,A,,13.03,10.93,NA,10.93,,2.77,26.73,26.73,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,90427457,,Realignment of knee,A,,13.68,9.76,NA,9.76,,2.91,26.35,26.35,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,90527458,,Osteot femur imed lngth dev,A,,26.65,20.06,NA,20.06,,5.13,51.84,51.84,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,90627465,,Shortening of thigh bone,A,,20.60,13.74,NA,13.74,,4.39,38.73,38.73,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,90727466,,Lengthening of thigh bone,A,,22.08,14.21,NA,14.21,,4.71,41.00,41.00,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4906102,IL,12,EAST ST. LOUIS,1.000,0.920,2.014
5006102,IL,15,SUBURBAN CHICAGO,1.007,1.027,1.772
5106102,IL,99,REST OF ILLINOIS,1.000,0.913,1.563
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915