No office rate
Choose 27454 when the osteotomy realigns the distal femur; 27455 is for realignment at the tibia.
On this page
CMS RVU26D · Effective 2026-10-01
27454 Femoral osteotomy Medicare reimbursement rates in Kansas
Corrects alignment deformity at the distal femur by surgically cutting and repositioning the bone, typically to improve alignment around the knee. Compare 27454 office and facility rates across CMS payment localities in Kansas.
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 27454 in Kansas?
Kansas 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
$1074.73
1 of 1 localities have a supported rate.
Payment area: Kansas
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 27454: Distal femoral realignment osteotomy
Corrects alignment deformity at the distal femur by surgically cutting and repositioning the bone, typically to improve alignment around the knee.
This procedure corrects a deformity by cutting the distal femur and repositioning the bone to change its alignment. An orthopedic surgeon may perform it for a femoral deformity that affects knee alignment, such as a varus or valgus deformity. The bone may be stabilized with fixation as part of the operation. The operative report should identify the femoral site, the deformity being corrected, and the realignment performed.
Report the code for distal femoral realignment, rather than an osteotomy whose purpose is shortening or lengthening the femur. The record should support the need for correction and describe the bone work and fixation. This major surgery has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery services may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 27454
- 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 RVU18.69 · 53%
- Practice expense (office) RVU12.70 · 36%
- Malpractice RVU3.98 · 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.
27454 compared with similar codes
Office rates for Kansas, from the same CMS release.
No office rate
Both concern realignment around the knee, but 27454 identifies femoral correction and 27457 identifies tibial correction.
No office rate
This code addresses distal femoral realignment. Code 27458 is associated with femoral osteotomy for lengthening, not the alignment correction described here.
No office rate
Use 27454 for distal femoral realignment; 27466 describes femoral lengthening rather than correction of alignment.
Compare 27454 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
Kansas →
Office / nonfacility
Unavailable
Facility
$1074.73
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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 27454 in Kansas.
PPRRVU2026_Oct_nonQPP.csv
2,902
- Code
- 27454
- Physician work
- 18.69
- Practice expense
- 12.70
- Malpractice
- 3.98
GPCI2026.csv
54
- Locality
- Kansas
- Physician work
- 1.000
- Practice expense
- 0.904
- Malpractice
- 0.504
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 18.69 | × 1.000 | 18.6900 |
| Practice expense | 12.70 | × 0.904 | 11.4808 |
| Malpractice | 3.98 | × 0.504 | 2.0059 |
| Total RVUs | 32.1767 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Kansas$1074.73
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 18.69 | 1 |
| Practice expense | 12.7 | 0.904 |
| Malpractice | 3.98 | 0.504 |
(18.69 × 1 + 12.7 × 0.904 + 3.98 × 0.504) × $33.4009 = $1074.73
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.
27454 billing questions
How is this different from a tibial realignment osteotomy?
This code is for realignment at the distal femur. Codes 27455 and 27457 apply when the corrective osteotomy is at the tibia.
What documentation supports reporting this code?
Document the femoral deformity and site, the reason for correction, and the osteotomy and realignment performed. The operative report should also describe fixation when used.
Does the code include related postoperative visits?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How are multiple procedures in the same session paid?
The highest-valued procedure is paid in full, and other procedures are paid at 50% under the standard multiple procedure reduction.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery services may be paid. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
How is a bilateral procedure reported?
When performed bilaterally, report modifier 50; CMS pays the bilateral procedure at 150%.
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.
2,89927447,,Total knee arthroplasty,A,,19.11,11.58,NA,11.58,,4.02,34.71,34.71,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,90027448,,Incision of thigh,A,,11.31,9.11,NA,9.11,,2.41,22.83,22.83,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,90127450,,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
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
5607202,LA,01,NEW ORLEANS,1.000,0.941,1.136
5707202,LA,99,REST OF LOUISIANA,1.000,0.885,0.958