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CPT code 27403: Meniscus repair, open arthrotomy2026 Medicare rate & RVUs

Report open surgical repair of a torn knee meniscus when the surgeon exposes the joint through an arthrotomy and repairs the tissue.

CMS RVU26DEffective Oct 1, 2026109 payment localities782 Medicare services in 2024

Medicare pays $610.57 for 27403 nationally in a facility.

Medicare rate · 27403

Meniscus repair, open arthrotomy

Office or facility?

Work RVUs
8.4
Total RVUs
18.28
Global days
090

National rate · 2026

$610.57

Facility setting, before claim adjustments.

See every locality for 27403 →Billed by an NP, PA or therapist? →

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

Your location

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What 27403 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 27403 covers

This code describes open repair of a torn meniscus, the crescent-shaped cartilage pad in the knee joint. An orthopedic surgeon exposes the joint through an arthrotomy and repairs the meniscal tissue, typically in an operating room. It is distinct from arthroscopic meniscus repair, which uses a scope and small portals rather than an open joint exposure.

Report the code when the operative record supports an open meniscal repair, including the tear treated and the repair performed. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For bilateral procedures reported with modifier 50, CMS pays at 150%. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and the others at 50%. An assistant at surgery may be paid; 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 27403 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

27403 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$551.15
AlaskaUnavailable$742.09
ArizonaUnavailable$593.70
ArkansasUnavailable$543.82
Atlanta, GAUnavailable$627.57
Austin, TXUnavailable$620.16
Bakersfield, CAUnavailable$618.95
Baltimore area, MDUnavailable$648.79
Beaumont, TXUnavailable$581.99
Brazoria, TXUnavailable$597.44

27403 rates by state

Office rate range in each state. Select a state to see its payment localities.

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Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

View every state and territory as a table
27403 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 27403 rate is calculated

Each of 27403’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 · 27403

RVUs × geographic indexes × conversion factor

Office or facility?

Work8.40

8.40 RVUs× 1.000 GPCI

Practice expense8.12

8.12 RVUs× 1.000 GPCI

Malpractice1.76

1.76 RVUs× 1.000 GPCI

Adjusted RVUs

18.2800

Conversion factor

$33.4009

Medicare rate

$610.57

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 27403

27403 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 27403

Meniscus repair, open arthrotomy

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
Assistant at surgery (80/81/82/AS)2Paid.
Co-surgeons (62)1Permitted with supporting documentation.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.69/0.21Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 27403

Meniscus repair, open arthrotomy

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.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 50 · payment effect

With and without the modifier

27403 without 50 · national facility

$610.57

Meniscus repair, open arthrotomy

27403-50 · Bilateral: 150%

$915.86

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).

When to use modifier 50

27403 compared with similar codes

Compare codes · National

5 codes, side by side

Office or facility?

  • 27403

    Meniscus repair, open arthrotomy8.4 wRVU

    Not priced

  • 29882

    Meniscus repair, medial or lateral9.36 wRVU

    Not priced

  • 29883

    Meniscus repair, medial and lateral11.48 wRVU

    Not priced

  • 29881

    Knee meniscectomy, medial or lateral meniscus6.85 wRVU

    Not priced

  • 27405

    Knee ligament repair, primary collateral repair8.85 wRVU

    Not priced

How to choose

29882Meniscus repairMedial or lateral
This code is for open meniscal repair. Code 29882 describes arthroscopic repair of one meniscus.
29883Meniscus repairMedial and lateral
This code is for open meniscal repair. Code 29883 describes arthroscopic repair of both menisci.
29881Knee meniscectomyMedial or lateral meniscus
Use this code for open repair of meniscal tissue; 29881 describes arthroscopic removal of meniscal tissue rather than repair.
27405Knee ligament repairPrimary collateral repair
This code repairs a knee meniscus. Code 27405 concerns repair of a knee ligament, a different structure.

Codes related to 27403

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 27403
CodeHow it relatesNational office range
Used instead
29882Meniscus repair, medial or lateralArthroscopic repair of one meniscus rather than open repair.No office rate
29883Meniscus repair, medial and lateralArthroscopic repair of both menisci rather than open repair.No office rate
29881Knee meniscectomy, medial or lateral meniscusArthroscopic removal of meniscal tissue when resection, not repair, is performed.No office rate
29880Knee meniscectomy, medial and lateral menisciArthroscopic removal of tissue from both menisci when resection, not repair, is performed.No office rate

27403 billing questions

When should this code be used instead of an arthroscopic meniscus repair code?

Use this code for an open meniscal repair performed through an arthrotomy. Arthroscopic repair is reported with 29882 for one meniscus or 29883 when both are repaired.

Can meniscectomy be reported instead when the meniscus is removed?

No. Meniscal resection rather than repair points to a meniscectomy code, such as 29881 for one meniscus or 29880 for both, when performed arthroscopically.

What documentation supports reporting open meniscus repair?

Document the affected knee, meniscus and tear, the open approach, and the repair performed. The operative report should distinguish repair from removal or arthroscopic treatment.

How does the 90-day global period affect postoperative billing?

The day-before preoperative visit and 90 days of related postoperative care are included in the global period.

How is bilateral repair handled under the CMS rules?

Report modifier 50 for a bilateral procedure; CMS pays the bilateral procedure at 150%.

May an assistant or co-surgeon be reported?

An assistant at surgery may be paid. 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
RVUs for 27403PPRRVU2026_Oct_nonQPP.csv, line 2,875 (RVU26D)

Open CMS sourceHow we calculate rates

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