Billing code 27158: Pelvic osteotomyMedicare rate & RVUs in Texas
Reports bilateral pelvic osteotomy to correct hip alignment, such as for congenital hip dislocation, with open reduction included when performed.
CMS doesn’t publish an office rate for 27158 in Texas.
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 27158 covers
An orthopedic surgeon performs this bilateral pelvic osteotomy to reposition or reshape the pelvis as part of correcting hip alignment, commonly for congenital hip dislocation or developmental hip dysplasia. The operation is performed in the operating room; open reduction of the hip is included when performed as part of the procedure. This code identifies the bilateral pelvic service, rather than a femoral osteotomy or hip replacement.
Select the code from the operative report’s documented procedure and laterality, including the pelvic bone work and whether open reduction was performed. CMS prices this code as bilateral, so modifier 50 does not increase payment. It has a 90-day global period, which includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple procedure reduction. Assistant-at-surgery payment may be allowed; co-surgeon and team-surgery payment are 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.
Where 27158 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | Unavailable | $1,277.67 |
| Beaumont | Unavailable | $1,217.91 |
| Brazoria | Unavailable | $1,237.07 |
| Dallas | Unavailable | $1,251.30 |
| Fort Worth | Unavailable | $1,248.83 |
| Galveston | Unavailable | $1,244.94 |
| Houston | Unavailable | $1,324.74 |
| Rest Of Texas | Unavailable | $1,231.16 |
How the 27158 rate is calculated
Each of 27158’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 · 27158
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 20.51Practice expense 13.08Malpractice 4.36
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 27158
27158 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 27158
Pelvic 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) | 2 | Already bilateral by definition: paid once at 100%. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 0 | Not permitted. |
| 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 · 27158
Pelvic 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 51 · payment effect
With and without the modifier
27158 without 51 · national facility
$1,267.56
Pelvic osteotomy
27158-51 · Second procedure: 50%
$633.78
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
27158 compared with similar codes
Compare codes
27158 vs 27156 vs 27146 vs 27147: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 27156Hip reconstruction
- Choose 27158 for bilateral pelvic osteotomy and 27156 for the unilateral counterpart; 27158 is already priced bilaterally.
- 27146Hip osteotomy
- 27146 describes a different pelvic bone osteotomy service. Select according to the specific operation documented, rather than using it for bilateral hip-correction osteotomy.
- 27147Hip osteotomy
- 27147 represents a different pelvic osteotomy procedure scope. Use 27158 when the documented service is bilateral pelvic osteotomy for hip correction.
27158 billing questions
When should the bilateral code be selected instead of 27156?
Use 27158 when the documented pelvic osteotomy is bilateral. Code 27156 is the unilateral counterpart.
Should modifier 50 be added?
No. CMS prices 27158 as bilateral, and modifier 50 does not increase payment.
Is open reduction separately reported with this procedure?
Open reduction of the hip is included when performed as part of the pelvic osteotomy reported with 27158.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant-at-surgery claim be submitted?
Assistant-at-surgery payment may be allowed. Co-surgeon and team-surgery payment are not permitted for this code.
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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