CPT code 27709: Osteotomy2026 Medicare rate & RVUs in Virginia
Surgical realignment by cutting both lower-leg bones is reported when correction requires osteotomy of the tibia and fibula during one operative session.
CMS doesn’t publish an office rate for 27709 in Virginia.
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 27709 covers
An osteotomy cuts and reshapes bone to change alignment. CPT 27709 is for operative correction involving both the tibia and fibula in the same lower leg, rather than an osteotomy limited to one bone. Orthopedic surgeons may use it to correct a structural deformity or malalignment when correcting both bones is part of the planned reconstruction. The service is generally performed in an operating room; fixation may be used as part of the surgeon’s technique.
Report the code when the operative record supports osteotomy of each bone. Documentation should identify the side, the reason for correction, and the work performed on the tibia and fibula. This major surgery code has a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When other procedures are performed in the same session, the highest-valued procedure is paid in full and additional procedures are subject to the standard 50% reduction. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team surgery is 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 27709 pays more and less in Virginia
| Payment locality | Office | Facility |
|---|---|---|
| Dc + Md/Va Suburbs | Unavailable | $1,160.34 |
| Virginia | Unavailable | $1,011.75 |
How the 27709 rate is calculated
Each of 27709’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 · 27709
RVUs × geographic indexes × conversion factor
Work17.04
17.04 RVUs× 1.000 GPCI
Practice expense11.06
11.06 RVUs× 1.000 GPCI
Malpractice3.37
3.37 RVUs× 1.000 GPCI
Adjusted RVUs
31.4700
Conversion factor
$33.4009
Medicare rate
$1,051.13
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 27709
27709 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 27709
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) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| 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 · 27709
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 50 · payment effect
With and without the modifier
27709 without 50 · national facility
$1,051.13
Osteotomy
27709-50 · Bilateral: 150%
$1,576.70
Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).
27709 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 27705Tibial osteotomy
- Use 27705 when the osteotomy is limited to the tibia. Report 27709 when the operation includes osteotomy of both the tibia and fibula.
- 27707Fibular osteotomy
- Use 27707 when the osteotomy is limited to the fibula. Report 27709 when both lower-leg bones are osteotomized.
- 27712Tibial osteotomy
- 27712 describes tibial realignment on an intramedullary rod. Choose based on the procedure performed, rather than using it for a general osteotomy of both bones.
- 27715Bone length correction
- 27715 is for tibial and fibular lengthening or shortening. 27709 represents osteotomy of both bones for correction when that lengthening-or-shortening service is not the procedure performed.
27709 billing questions
When should I report 27709 instead of 27705 or 27707?
Report 27709 when the operative service includes an osteotomy of both the tibia and fibula in the same lower leg. Use 27705 for tibial osteotomy alone or 27707 for fibular osteotomy alone.
Does the code include osteotomy of both bones on both legs?
The code describes work on the tibia and fibula of a lower leg. For bilateral procedures, CMS payment uses modifier 50 and is 150%; the record should support the work on each side.
What documentation supports reporting 27709?
Document the indication and side, and describe the osteotomy performed on each bone and the intended correction. The record should make clear why both bones required operative correction.
How does the 90-day global period affect follow-up visits?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period. Routine follow-up care related to the osteotomy falls within that period.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full, and other procedures in the same session are subject to the standard multiple procedure reduction, with payment at 50%.
Can an assistant or co-surgeon be paid for this operation?
Assistant-at-surgery payment may be available. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
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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