Osteotomy and distal-lateral transfer of the greater trochanter of the femur, reported as a separate procedure.
Verified May 8, 2026 · 6 sources ↓
- Medicare
- $830.35
- Total RVUs
- 24.86
- Global, days
- 90
- Region
- Hip
Documentation requirements
What must appear in the operative or office note to support the claim.
Source · Editorial brief grounded in 6 cited references ↓
- Specify the indication: coxa vara, abductor dysfunction, trochanteric overgrowth, or impingement — vague 'hip deformity' invites medical necessity denial.
- Describe the osteotomy technique: type of cut, direction of transfer (distal, lateral, or both), and fixation method (screws, wires, cables).
- Record intraoperative imaging used to confirm trochanteric position and hardware placement.
- Document failed or contraindicated conservative management prior to surgical intervention.
- Note laterality explicitly (left, right, or bilateral) in both the operative report and the procedure order.
- Include pre-op imaging (X-ray, CT) that quantifies the deformity and supports the planned correction.
Applicable modifiers
Modifiers commonly billed with this code.
Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual
What this code covers
Source · Editorial summary grounded in 6 cited references ↓
CPT 27140 covers the surgical detachment and repositioning of the greater trochanter — the bony prominence on the proximal-lateral femur where the hip abductors attach. The surgeon cuts the trochanter free, then translates it distally and laterally before reattaching it with hardware. The goal is to restore or improve abductor mechanics, correct coxa vara, or address trochanteric overgrowth that limits hip motion or causes impingement.
This is a 90-day global procedure. All routine post-op visits, wound checks, and hardware monitoring within that window are bundled. Separate E/M visits during the global require modifier 24 (unrelated condition) or modifier 79 (unrelated surgical procedure). Staged procedures in the same global — for example, hardware removal planned at the time of the index surgery — use modifier 58.
Site of service matters for reimbursement. HOPD and ASC facility payments differ substantially; see the Site of Service comparison table on this page. When 27140 is performed bilaterally, append modifier 50 or report it with LT/RT on separate lines per payer preference. Confirm with the payer — Medicare accepts modifier 50 on a single line; some commercial payers require two lines.
RVU & reimbursement
Component RVUs and Medicare national rate. Actual payment varies by GPCI locality.
Source · CMS Physician Fee Schedule, RVU26A · January 2026
| Work RVU | 12.46 |
| Practice expense RVU | 9.75 |
| Malpractice RVU | 2.65 |
| Total RVU | 24.86 |
| Medicare national rate | $830.35 |
| Global period | 90 days |
Payment by site of service
Medicare pays different rates by setting. HOPD typically pays substantially more than ASC for the same procedure.
Source · CMS OPPS Addendum B·ASC HCPCS payment rates·2026
| Setting | Medicare rate (national) |
|---|---|
Office (PFS non-facility) Procedure performed in physician's office | $830.35 |
HOPD (APC 5114) Hospital outpatient department | $7,413.38 |
ASC (PI G2) Ambulatory surgical center (freestanding) | $3,695.53 |
Common denial reasons
The recurring reasons claims for CPT 27140 get rejected.
Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓
- Medical necessity not established — operative note lacks pre-op imaging findings or failed conservative care history.
- Laterality mismatch between the claim, the operative report, and the authorization on file.
- Global period conflict — post-op E/M billed without modifier 24 when unrelated, or without modifier 58 for staged hardware removal.
- Missing or incorrect modifier when billed bilaterally — payer expected two-line LT/RT but received a single-line modifier 50, or vice versa.
- Procedure billed without supporting diagnosis code that maps to an accepted indication for trochanteric transfer.
Frequently asked questions
Source · Generated from the editorial pipeline, verified against 6 cited references ↓
01Is 27140 ever billed with a total hip arthroplasty on the same day?
02What modifier do I use for a planned hardware removal after 27140?
03Can 27140 be billed bilaterally?
04What ICD-10 codes typically pair with 27140?
05Does the 90-day global include physical therapy referrals and DME orders?
06How does modifier 22 apply to a particularly complex trochanteric transfer?
Sources & references
Editorial content was developed using the following public sources. Last verified May 8, 2026.
- 01CMS Physician Fee Schedule 2026
- 02aapc.comhttps://www.aapc.com/codes/cpt-codes/27140
- 03vsac.nlm.nih.govhttps://vsac.nlm.nih.gov/context/cs/codesystem/CPT/version/2020/code/27140/info
- 04cms.govhttps://www.cms.gov/files/document/04-chapter4-ncci-medicare-policy-manual-2025finalcleanpdf.pdf
- 05cms.govhttps://www.cms.gov/medicare/regulations-guidance/physician-self-referral/list-cpt-hcpcs-codes
- 06mdclarity.comhttps://www.mdclarity.com/cpt-code/27140
Mira AI Scribe
Mira's AI scribe captures the specific indication (coxa vara angle, abductor insufficiency grade, impingement source), the osteotomy technique, direction and magnitude of trochanteric transfer, fixation hardware used, and intraoperative imaging confirmation from the surgeon's dictation. That detail closes the medical necessity gap that triggers denials when operative notes read as generic 'hip reconstruction' without deformity quantification.
See how Mira captures CPT 27140 documentation