Billing code 27477: Growth arrest surgeryMedicare rate & RVUs in Washington
Percutaneous epiphysiodesis of the proximal tibia is reported when a surgeon arrests growth at that physis to manage a developing limb-length discrepancy.
CMS doesn’t publish an office rate for 27477 in Washington.
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 27477 covers
This service is percutaneous epiphysiodesis at the proximal tibial growth plate. A pediatric orthopedic surgeon may perform it to limit growth in the affected tibia as part of a plan to address a predicted limb-length discrepancy. The approach is percutaneous rather than an open exposure; the operative record should identify the treated physis and describe the method used to arrest growth.
Report this code for the proximal tibia, not the distal femur alone or both sites together. Documentation should support the clinical growth-arrest plan, the anatomic site, and the percutaneous approach. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one 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 is restricted; co-surgeons require 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 27477 pays more and less in Washington
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Washington | Unavailable | $690.13 |
| Seattle (King Cnty) | Unavailable | $756.20 |
How the 27477 rate is calculated
Each of 27477’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 · 27477
RVUs × geographic indexes × conversion factor
Work9.89
9.89 RVUs× 1.000 GPCI
Practice expense8.59
8.59 RVUs× 1.000 GPCI
Malpractice2.10
2.10 RVUs× 1.000 GPCI
Adjusted RVUs
20.5800
Conversion factor
$33.4009
Medicare rate
$687.39
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 27477
27477 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 27477
Growth arrest surgery
| 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) | 1 | Not paid (statutory restriction). |
| 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 · 27477
Growth arrest surgery
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
27477 without 50 · national facility
$687.39
Growth arrest surgery
27477-50 · Bilateral: 150%
$1,031.09
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).
27477 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 27475Growth arrest
- Both describe percutaneous growth arrest, but 27475 identifies the distal femur and 27477 the proximal tibia.
- 27479Growth arrest
- 27479 covers percutaneous epiphysiodesis at both the distal femur and proximal tibia; 27477 is for the proximal tibia site.
- 27485Guided growth
- 27485 describes an open epiphysiodesis approach. Choose 27477 for percutaneous treatment at the proximal tibia.
27477 billing questions
How does 27477 differ from 27475?
27477 is for percutaneous growth arrest at the proximal tibia. 27475 is for the distal femur.
When is 27479 a better fit?
Use 27479 when the percutaneous epiphysiodesis treats both the distal femur and proximal tibia. 27477 identifies the proximal tibia site alone.
What documentation supports 27477?
The operative record should identify the proximal tibial physis, establish the growth-arrest intent, and describe the percutaneous approach.
How is bilateral treatment reported under the CMS rule?
For a bilateral procedure, report modifier 50; CMS payment for the bilateral procedure is 150%.
Are related postoperative visits included?
Yes. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be paid for this procedure?
CMS restricts assistant-at-surgery payment. Co-surgeons are paid only with supporting documentation, and 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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