Surgical osteoplasty of both the tibia and fibula to correct leg length discrepancy, either by lengthening or shortening the bones.

Verified May 8, 2026 · 5 sources ↓

Medicare: $1,362.09
Total RVUs: 40.78
Global, days: 90
Region: Foot & ankle

Drawn from CMSAAPCFindacodeGenhealthPayerprice

Documentation requirements

What must appear in the operative or office note to support the claim.

Source · Editorial brief grounded in 5 cited references ↓

Specify whether the procedure is a lengthening or shortening and identify the bone(s) involved (tibia, fibula, or both).
Document the clinical diagnosis of leg length discrepancy with objective measurements — standing scanogram or full-length radiograph measurements in centimeters.
Describe the surgical technique in detail: osteotomy method, fixation device used, and amount of correction achieved.
Record pre- and post-correction limb length measurements in the operative note.
Identify the operative extremity (left or right) explicitly in the note and on the claim.
Include any bone graft use — autograft or allograft — as this may support separate graft codes.
Document conservative treatment attempted prior to surgical intervention to satisfy medical necessity requirements.

Applicable modifiers

Modifiers commonly billed with this code.

Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual

22 Increased complexity 51 Multiple procedures 52 Reduced services 58 Staged or related 59 Distinct service 62 Co-surgeons 78 Unplanned return — related 79 Unrelated during global 80 Assistant surgeon LT Left side RT Right side XS Separate structure

What this code covers

Source · Editorial summary grounded in 5 cited references ↓

CPT 27715 covers osteoplasty of the tibia and fibula performed to address leg length discrepancy. The surgeon modifies one or both bones — either lengthening (typically via osteotomy with distraction or bone graft interposition) or shortening (via segmental resection) — to equalize limb lengths. Both lengthening and shortening approaches bill under the same code; the operative note must make the direction of correction explicit.

This is a high-complexity procedure carrying a 90-day global period. All routine postoperative management, wound care, and follow-up visits through day 90 are bundled. Use modifier 24 for unrelated E/M visits and modifier 78 for unplanned returns to the OR for a related complication within the global window. Modifier 79 applies if an unrelated surgical procedure is performed during the global period.

Site of service matters significantly here. HOPD and ASC facility payments differ substantially — see the Site of Service comparison table. Because this procedure is almost always performed in an inpatient or outpatient hospital setting, place of service 21 or 22 is standard. Laterality modifiers LT and RT are required when the operative side must be identified for the payer.

RVU & reimbursement

Component RVUs and Medicare national rate. Actual payment varies by GPCI locality.

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU	21.94
Practice expense RVU	14.16
Malpractice RVU	4.68
Total RVU	40.78
Medicare national rate	$1,362.09
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	$1,362.09
HOPD (APC 5115) Hospital outpatient department	$13,116.76
ASC (PI J8) Ambulatory surgical center (freestanding)	$9,493.97

Common denial reasons

The recurring reasons claims for CPT 27715 get rejected.

Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓

Medical necessity not established — payer requires documented failed conservative management or minimum discrepancy threshold not met.
Missing or ambiguous laterality on the claim; LT/RT modifier absent triggers automatic rejection by many payers.
Operative note fails to specify the direction of correction (lengthening vs. shortening) or the technique used, flagging the claim for audit.
Bundling conflicts when osteotomy codes (e.g., 27705, 27709) are billed same-session without proper modifier 59 or XS to distinguish distinct procedures.
Prior authorization not obtained — high-complexity musculoskeletal reconstruction procedures almost universally require precertification.

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 5 cited references ↓

01Does 27715 cover both lengthening and shortening on the same claim?

Yes. The code is written for either approach. You do not bill separate codes for lengthening versus shortening — the operative note just needs to state which was performed and document the technique.

02Can 27715 be billed with osteotomy codes like 27705 or 27709 on the same day?

Only if a distinct, separately identifiable osteotomy procedure was performed on a different bone segment or for a different indication. Use modifier 59 or XS to bypass bundling edits, and ensure the operative note supports two separate procedures.

03What is the global period for 27715 and what does it include?

The global period is 90 days. It bundles the day-before visit, the surgery, and all routine postoperative care through day 90. Unrelated visits need modifier 24; unplanned returns to the OR for a related issue need modifier 78.

04Is modifier 50 appropriate when both legs are operated on in the same session?

Bilateral leg length correction in the same session is uncommon, but if performed, modifier 50 applies. Document both sides clearly in the operative note. Most payers will price the second side at 50% of the allowable.

05What ICD-10 diagnosis codes typically support medical necessity for 27715?

Q72.8x series (congenital limb length discrepancy), M21.7x series (unequal limb length, acquired), and post-traumatic or post-surgical limb length discrepancy codes are the standard supporting diagnoses. The specific code depends on etiology — congenital versus acquired.

06Is prior authorization required for 27715?

Virtually all commercial payers and many Medicare Advantage plans require prior authorization for this high-complexity reconstruction. Obtain it before scheduling; retro-authorization is rarely granted.

07Can modifier 22 be used if the procedure was significantly more complex than typical?

Yes, if the work was substantially greater than typical — for example, revision surgery with difficult anatomy or hardware removal complicating the osteoplasty. Attach a cover letter quantifying the additional time and complexity, and expect the payer to request operative notes.

Sources & references

Editorial content was developed using the following public sources. Last verified May 8, 2026.

Mira AI Scribe

Mira's AI scribe captures the direction of correction (lengthening vs. shortening), bones modified, osteotomy technique, fixation method, and pre- and post-op limb length measurements directly from dictation. That specificity prevents the two most common audit flags for 27715: an operative note that omits the correction direction and a claim missing laterality. The scribe also flags when bone graft use is dictated, prompting review for separately reportable graft codes.

See how Mira captures CPT 27715 documentation