No office rate
27147 describes the pelvic osteotomy performed with a femoral osteotomy. Use 27146 when the documented work is limited to the pelvic bone.
On this page
CMS RVU26D · Effective 2026-10-01
27146 Hip osteotomy Medicare reimbursement rates in Virginia
Reports an osteotomy of the iliac, acetabular, or innominate bone to change hip alignment, such as for acetabular dysplasia. Compare 27146 office and facility rates across CMS payment localities in Virginia.
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 27146 in Virginia?
Virginia has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$1123.27–$1292.17
2 of 2 localities have a supported rate.
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 27146: Pelvic bone osteotomy for hip alignment
Reports an osteotomy of the iliac, acetabular, or innominate bone to change hip alignment, such as for acetabular dysplasia.
The surgeon cuts and repositions part of the pelvis to improve the position or coverage of the hip socket. Orthopedic surgeons commonly perform this operation for hip-preservation needs, including acetabular dysplasia; pediatric cases may involve developmental hip conditions. A Salter-type pelvic osteotomy is a familiar example. The code represents the pelvic bone work, not an osteotomy confined to the femur.
Select the code from the operative report’s description of the bone treated and the procedures performed. Document the indication, laterality, pelvic bone work, and whether a femoral osteotomy was also performed; the combined pelvic and femoral procedure is distinguished by 27147. This major surgery has a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures 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 27146
- 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 RVU18.45 · 53%
- Practice expense (office) RVU12.62 · 36%
- Malpractice RVU3.93 · 11%
46
Medicare services in 2024 · #5398 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.
27146 compared with similar codes
Office rates for Virginia, from the same CMS release.
No office rate
27161 is directed to an osteotomy of the femoral neck. Code 27146 is for osteotomy of the iliac, acetabular, or innominate bone.
No office rate
27165 concerns femoral osteotomy with fixation; 27146 concerns pelvic bone osteotomy.
No office rate
27130 reports total hip arthroplasty, which replaces the hip joint. Code 27146 reports pelvic bone realignment rather than joint replacement.
Compare 27146 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.
2 of 2 payment localities
Dc + Md/Va Suburbs →
Office / nonfacility
Unavailable
Facility
$1292.17
Virginia →
Office / nonfacility
Unavailable
Facility
$1123.27
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27146 billing questions
When should 27146 be selected instead of 27147?
Use 27146 when the documented osteotomy is of the iliac, acetabular, or innominate bone without a femoral osteotomy. Code 27147 identifies the combined pelvic and femoral osteotomy.
What operative documentation supports 27146?
The report should identify the pelvic bone treated, the osteotomy and repositioning performed, the indication, and the side. It should also clarify whether a femoral osteotomy was part of the operation.
How is bilateral 27146 reported?
Report bilateral work with modifier 50. CMS pays bilateral procedures at 150%.
What global period applies to this surgery?
The 90-day global period includes the day-before preoperative visit and related postoperative care during the 90 days after surgery.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery services may be paid. Co-surgeons are paid only when supporting documentation is provided; team surgery is not permitted.
How does CMS handle other procedures performed in the same session?
The highest-valued procedure is paid in full, and other procedures are paid at 50% under the standard multiple procedure reduction.
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.
2,76327137,,Revise hip joint replacement,A,,22.13,12.61,NA,12.61,,4.71,39.45,39.45,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,76427138,,Revise hip joint replacement,A,,23.11,12.92,NA,12.92,,4.90,40.93,40.93,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,76527140,,Transplant femur ridge,A,,12.46,9.75,NA,9.75,,2.65,24.86,24.86,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,76627146,,Incision of hip bone,A,,18.45,12.62,NA,12.62,,3.93,35.00,35.00,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,76727147,,Revision of hip bone,A,,21.52,13.60,NA,13.60,,4.58,39.70,39.70,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,76827151,,Incision of hip bones,A,,23.52,14.24,NA,14.24,,5.01,42.77,42.77,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,76927156,,Revision of hip bones,A,,25.57,14.89,NA,14.89,,5.45,45.91,45.91,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00