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

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, 2026One payment locality782 Medicare services in 2024

In South Dakota, Medicare pays $571.53 for 27403 in a facility. There’s no office rate.

Not available in this settingOffice (non-facility)
$571.53Hospital or facility

Check a contract rate as a % of Medicare · 27403 nationwide

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

We’ll open 27403 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in South Dakota
  2. What 27403 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. 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.

How South Dakota compares for 27403

Across 109 of 109 payment localities, the facility rate for 27403 runs from $543.82 in Arkansas to $742.09 in Alaska. South Dakota pays $571.53. The RVUs are the same everywhere; the geographic indexes change the dollars.

27403 in South Dakota vs other payment areas
  1. South Dakota · this page$571.53
  2. Los Angeles, CA · California$651.95+$80.42
  3. Washington, DC area · District of Columbia$680.64+$109.11
  4. Miami, FL · Florida$711.57+$140.04
  5. Chicago, IL · Illinois$690.02+$118.49
  6. Manhattan, NY · New York$706.91+$135.38
  7. Alaska · Alaska$742.09+$170.56

Other areas in South Dakota first, then benchmark localities. Bars start at $0.

Every other payment area

27403 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama—$551.15
ArkansasArkansas—$543.82
ArizonaArizona—$593.70
Bakersfield, CACalifornia—$618.95
Chico, CACalifornia—$614.10
El Centro, CACalifornia—$614.39
Fresno, CACalifornia—$614.10
Hanford, CACalifornia—$614.10

27403 rates by state

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

Explore a state

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

See 27403 in every payment locality

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.

The exact South Dakota inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

2,875

Code
27403
Physician work
8.40
Practice expense
8.12
Malpractice
1.76

GPCI2026.csv

94

Locality
South Dakota
Physician work
1.000
Practice expense
1.000
Malpractice
0.336
Facility calculation for 27403 in South Dakota
ComponentRVULocality factorAdjusted
Physician work8.40× 1.0008.4000
Practice expense8.12× 1.0008.1200
Malpractice1.76× 0.3360.5914
Total RVUs17.1114
Conversion factor× 33.4009

Facility rate, South Dakota$571.53

Facility: (8.4 × 1 + 8.12 × 1 + 1.76 × 0.336) × $33.4009 = $571.53

Open 27403 in the RVU calculator

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

How 27403 has changed in South Dakota

27403 · Office / nonfacility

Rate unavailable

Effective 2026-10-01

A rate is unavailable in one of these releases, so a change cannot be calculated.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release
Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01Not available in this setting$571.53RVU26D
2026-07-01Not available in this setting$571.53RVU26C
2026-04-01Not available in this setting$571.53RVU26B
2026-01-01Not available in this setting$571.53RVU26A
2025-10-01Not available in this setting$607.42RVU25D
2025-07-01Not available in this setting$607.42RVU25C
2025-04-01Not available in this setting$607.42RVU25B
2025-01-01Not available in this setting$607.42RVU25A
2024-10-01Not available in this setting$618.89RVU24D
2024-07-01Not available in this setting$618.89RVU24C
2024-04-01Not available in this setting$618.89RVU24B
2024-03-09Not available in this setting$618.89RVU24AR
2024-01-01Not available in this setting$608.79RVU24A
2023-10-01Not available in this setting$622.93RVU23D
2023-07-01Not available in this setting$622.93RVU23C
2023-04-01Not available in this setting$622.93RVU23B
2023-01-01Not available in this setting$622.93RVU23A
2022-10-01Not available in this setting$625.93RVU22D
2022-07-01Not available in this setting$625.93RVU22C
2022-04-01Not available in this setting$625.93RVU22B
2022-01-01Not available in this setting$625.93RVU22A
2021-10-01Not available in this setting$626.80RVU21D
2021-07-01Not available in this setting$626.80RVU21C
2021-04-01Not available in this setting$626.80RVU21B
2021-01-01Not available in this setting$626.80RVU21A
2020-10-01Not available in this setting$631.28RVU20D
2020-07-01Not available in this setting$631.28RVU20C
2020-04-01Not available in this setting$631.28RVU20B
2020-01-01Not available in this setting$631.28RVU20A
2019-10-01Not available in this setting$627.35RVU19D
2019-07-01Not available in this setting$627.35RVU19C
2019-04-01Not available in this setting$627.35RVU19B
2019-01-01Not available in this setting$627.35RVU19A
2018-10-01Not available in this setting$624.14RVU18D
2018-07-01Not available in this setting$624.14RVU18C
2018-04-01Not available in this setting$624.14RVU18B
2018-01-01Not available in this setting$624.14RVU18AR1
2017-10-01Not available in this setting$622.01RVU17D
2017-07-01Not available in this setting$622.01RVU17C
2017-04-01Not available in this setting$622.01RVU17B
2017-01-01Not available in this setting$622.01RVU17A
2016-10-01Not available in this setting$621.35RVU16D
2016-07-01Not available in this setting$621.35RVU16C
2016-04-01Not available in this setting$621.35RVU16B
2016-01-01Not available in this setting$621.35RVU16A
2015-10-01Not available in this setting$624.67RVU15D
2015-07-01Not available in this setting$624.67RVU15C
2015-04-01Not available in this setting$621.56RVU15B
2015-01-01Not available in this setting$621.56RVU15A
2014-10-01Not available in this setting$619.94RVU14D
2014-07-01Not available in this setting$619.94RVU14C
2014-04-01Not available in this setting$619.94RVU14B
2014-01-01Not available in this setting$619.94RVU14A
2013-10-01Not available in this setting$615.53RVU13D
2013-07-01Not available in this setting$615.53RVU13C
2013-04-01Not available in this setting$615.53RVU13B
2013-01-01Not available in this setting$615.53RVU13AR

Price 27403 for an earlier date of service

Where the South Dakota rate applies

South Dakota is a Medicare payment area, not a city. Our Census mapping connects it to 485 cities and communities in South Dakota. Some span more than one payment area; confirm with the service ZIP.

  • Aberdeen
  • Agar
  • Agency Village
  • Akaska
  • Albee
  • Alcester
  • Alexandria
  • Allen

Browse all communities in South Dakota

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)
Geographic factors for South DakotaGPCI2026.csv, line 94 (RVU26D)

Open CMS sourceHow we calculate rates

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