No office rate
Choose 27178 for open SCFE treatment with corrective osteotomy. Choose 27177 when the open treatment involves proximal femoral epiphysiodesis.
On this page
CMS RVU26D · Effective 2026-10-01
27178 SCFE surgery Medicare reimbursement rates in Tennessee
Reports open operative treatment of slipped capital femoral epiphysis when the surgeon performs a corrective osteotomy, with fixation as indicated. Compare 27178 office and facility rates across CMS payment localities in Tennessee.
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 27178 in Tennessee?
Tennessee 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
$783.77
1 of 1 localities have a supported rate.
Payment area: Tennessee
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 27178: Slipped epiphysis open treatment with osteotomy
Reports open operative treatment of slipped capital femoral epiphysis when the surgeon performs a corrective osteotomy, with fixation as indicated.
This code is for open surgery to treat slipped capital femoral epiphysis (SCFE) that includes a corrective osteotomy of the proximal femur. The operation is generally performed by an orthopedic surgeon, often for an adolescent whose femoral head has displaced at the growth plate and requires operative correction. The operative report should make clear that treatment included the osteotomy, not just closed reduction or a different open treatment approach.
Report the code when the documented procedure matches that osteotomy-based treatment; include the affected side and describe the correction and any fixation performed. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. For bilateral procedures reported with modifier 50, CMS pays at 150%. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to a 50% reduction. An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 27178
- 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 RVU12.60 · 49%
- Practice expense (office) RVU10.37 · 40%
- Malpractice RVU2.68 · 10%
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.
27178 compared with similar codes
Office rates for Tennessee, from the same CMS release.
No office rate
27175 is closed treatment without manipulation. It does not describe the open osteotomy-based operation reported with 27178.
No office rate
27176 is closed treatment with manipulation, with or without skeletal traction. The open corrective osteotomy in 27178 distinguishes that code.
No office rate
27181 describes femoral neck osteotomy for SCFE. Compare the documented operative method and scope with the open treatment represented by 27178.
Compare 27178 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
Tennessee →
Office / nonfacility
Unavailable
Facility
$783.77
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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 27178 in Tennessee.
PPRRVU2026_Oct_nonQPP.csv
2,777
- Code
- 27178
- Physician work
- 12.60
- Practice expense
- 10.37
- Malpractice
- 2.68
GPCI2026.csv
95
- Locality
- Tennessee
- Physician work
- 1.000
- Practice expense
- 0.909
- Malpractice
- 0.537
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 12.60 | × 1.000 | 12.6000 |
| Practice expense | 10.37 | × 0.909 | 9.4263 |
| Malpractice | 2.68 | × 0.537 | 1.4392 |
| Total RVUs | 23.4655 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Tennessee$783.77
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 12.6 | 1 |
| Practice expense | 10.37 | 0.909 |
| Malpractice | 2.68 | 0.537 |
(12.6 × 1 + 10.37 × 0.909 + 2.68 × 0.537) × $33.4009 = $783.77
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.
27178 billing questions
How does this differ from 27177?
27178 describes open SCFE treatment with a corrective osteotomy. 27177 is the open treatment approach involving proximal femoral epiphysiodesis.
When would 27175 or 27176 be more appropriate?
Those codes describe closed treatment: 27175 without manipulation and 27176 with manipulation, with or without skeletal traction. Use 27178 when the documented operation includes open treatment with osteotomy.
Does the code include postoperative visits?
CMS assigns a 90-day global period. The day-before preoperative visit and related postoperative care during the 90 days are included.
Can modifier 50 be used for bilateral treatment?
CMS lists this as a bilateral procedure; with modifier 50, it is paid at 150%. The record should support treatment of both sides.
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.
What documentation supports reporting 27178?
The operative report should identify SCFE and describe the open corrective osteotomy, the side treated, and any fixation performed. The documented procedure must distinguish it from closed treatment or open treatment using another approach.
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.
2,77427175,,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
2,78027185,,Revision of femur epiphysis,A,,9.55,8.68,NA,8.68,,2.04,20.27,20.27,0,090,0.10,0.69,0.21,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
9214412,RI,01,RHODE ISLAND,1.019,1.033,0.892
9311202,SC,01,SOUTH CAROLINA,1.000,0.924,0.850
9403402,SD,02,SOUTH DAKOTA**,1.000,1.000,0.336
9510312,TN,35,TENNESSEE,1.000,0.909,0.537
9604412,TX,31,AUSTIN,1.002,1.058,0.886
9704412,TX,20,BEAUMONT,1.000,0.910,0.929
9804412,TX,09,BRAZORIA,1.008,0.991,0.780