CPT code 27416: Knee cartilage graft, autograft, open approach2026 Medicare rate & RVUs in New Mexico
Open transfer of a patient’s own osteochondral tissue treats a focal knee defect when healthy cartilage and underlying bone are grafted into the affected area.
In New Mexico, Medicare pays $893.76 for 27416 in a facility. There’s no office rate.
Check a contract rate as a % of Medicare · 27416 nationwide
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 11 sections
What 27416 covers
The surgeon harvests one or more plugs of cartilage and underlying bone from a less weight-bearing area of the patient’s knee and transfers them to a focal defect in the same knee. Orthopedic surgeons use this approach for selected cartilage and osteochondral injuries, including defects associated with osteochondritis dissecans. The service is performed through an open approach, commonly in a hospital or ambulatory surgery setting.
Report the code when the operative record supports open autologous osteochondral grafting, including the defect’s location and the harvest and recipient sites. Distinguish it from grafting with donor tissue or from cartilage-cell implantation. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For same-session procedures, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are 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 New Mexico compares for 27416
Across 109 of 109 payment localities, the facility rate for 27416 runs from $806.50 in Arkansas to $1,111.33 in Alaska. New Mexico pays $893.76. The RVUs are the same everywhere; the geographic indexes change the dollars.
- New Mexico · this page$893.76
- Los Angeles, CA · California$951.18+$57.42
- Washington, DC area · District of Columbia$999.56+$105.80
- Miami, FL · Florida$1,066.70+$172.94
- Chicago, IL · Illinois$1,034.60+$140.84
- Manhattan, NY · New York$1,045.13+$151.37
- Alaska · Alaska$1,111.33+$217.57
Other areas in New Mexico first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | — | $817.00 |
| ArkansasArkansas | — | $806.50 |
| ArizonaArizona | — | $877.72 |
| Bakersfield, CACalifornia | — | $905.79 |
| Chico, CACalifornia | — | $897.70 |
| El Centro, CACalifornia | — | $898.19 |
| Fresno, CACalifornia | — | $897.70 |
| Hanford, CACalifornia | — | $897.70 |
| Madera, CACalifornia | — | $897.70 |
| Merced, CACalifornia | — | $897.70 |
| Modesto, CACalifornia | — | $897.70 |
| Napa, CACalifornia | — | $992.32 |
| Oxnard, CACalifornia | — | $940.82 |
| Redding, CACalifornia | — | $897.70 |
| Rest of CaliforniaCalifornia | — | $897.70 |
| Riverside, CACalifornia | — | $929.29 |
| Sacramento, CACalifornia | — | $929.45 |
| Salinas, CACalifornia | — | $925.77 |
| San Diego, CACalifornia | — | $938.59 |
| Marin County, CACalifornia | — | $1,033.83 |
| San Francisco, CACalifornia | — | $1,030.49 |
| San Benito County, CACalifornia | — | $1,059.29 |
| Santa Clara County, CACalifornia | — | $1,045.64 |
| San Luis Obispo, CACalifornia | — | $912.45 |
| Santa Cruz, CACalifornia | — | $940.37 |
| Santa Maria, CACalifornia | — | $926.79 |
| Santa Rosa, CACalifornia | — | $948.98 |
| Stockton, CACalifornia | — | $897.70 |
| Vallejo, CACalifornia | — | $987.51 |
| Visalia, CACalifornia | — | $897.70 |
| Yuba City, CACalifornia | — | $897.70 |
| ColoradoColorado | — | $908.48 |
| ConnecticutConnecticut | — | $958.75 |
| DelawareDelaware | — | $890.76 |
| Fort Lauderdale, FLFlorida | — | $986.30 |
| Rest of FloridaFlorida | — | $936.79 |
| Atlanta, GAGeorgia | — | $929.10 |
| Rest of GeorgiaGeorgia | — | $884.30 |
| Hawaii, Guam, HIHawaii | — | $908.15 |
| IowaIowa | — | $814.12 |
| IdahoIdaho | — | $823.30 |
| East St. Louis, ILIllinois | — | $974.62 |
| Rest of IllinoisIllinois | — | $927.93 |
| Suburban Chicago, ILIllinois | — | $990.79 |
| IndianaIndiana | — | $826.98 |
| KansasKansas | — | $820.86 |
| KentuckyKentucky | — | $856.07 |
| New Orleans, LALouisiana | — | $895.61 |
| Rest of LouisianaLouisiana | — | $858.92 |
| Metropolitan Boston, MAMassachusetts | — | $977.15 |
| Rest of MassachusettsMassachusetts | — | $908.12 |
| Baltimore area, MDMaryland | — | $958.19 |
| Rest of MarylandMaryland | — | $903.17 |
| Rest of MaineMaine | — | $837.93 |
| Southern Maine, MEMaine | — | $863.17 |
| Detroit, MIMichigan | — | $957.85 |
| Rest of MichiganMichigan | — | $885.32 |
| MinnesotaMinnesota | — | $843.31 |
| Metropolitan Kansas City, MOMissouri | — | $879.31 |
| Metropolitan St. Louis, MOMissouri | — | $886.22 |
| Rest of MissouriMissouri | — | $852.60 |
| MississippiMississippi | — | $829.18 |
| MontanaMontana | — | $902.30 |
| North CarolinaNorth Carolina | — | $844.06 |
| North DakotaNorth Dakota | — | $844.16 |
| NebraskaNebraska | — | $815.00 |
| New HampshireNew Hampshire | — | $904.28 |
| Northern New JerseyNew Jersey | — | $993.11 |
| Rest of New JerseyNew Jersey | — | $962.03 |
| NevadaNevada | — | $886.44 |
| NYC suburbs and Long Island, NYNew York | — | $1,081.00 |
| Poughkeepsie and northern NYC suburbs, NYNew York | — | $976.46 |
| Queens, NYNew York | — | $1,037.85 |
| Rest of New YorkNew York | — | $856.18 |
| OhioOhio | — | $873.43 |
| OklahomaOklahoma | — | $843.89 |
| Portland, OROregon | — | $922.81 |
| Rest of OregonOregon | — | $871.96 |
| Metropolitan Philadelphia, PAPennsylvania | — | $943.81 |
| Rest of PennsylvaniaPennsylvania | — | $868.96 |
| Puerto RicoPuerto Rico | — | $904.79 |
| Rhode IslandRhode Island | — | $911.97 |
| South CarolinaSouth Carolina | — | $861.69 |
| South DakotaSouth Dakota | — | $837.29 |
| TennesseeTennessee | — | $825.81 |
| Austin, TXTexas | — | $912.12 |
| Beaumont, TXTexas | — | $864.65 |
| Brazoria, TXTexas | — | $881.49 |
| Dallas, TXTexas | — | $891.33 |
| Fort Worth, TXTexas | — | $889.17 |
| Galveston, TXTexas | — | $886.89 |
| Houston, TXTexas | — | $940.70 |
| Rest of TexasTexas | — | $875.47 |
| UtahUtah | — | $871.89 |
| VirginiaVirginia | — | $867.79 |
| Virgin Islands, VIUnited States Virgin Islands | — | $904.79 |
| VermontVermont | — | $850.55 |
| Rest of WashingtonWashington | — | $903.20 |
| King County, WAWashington | — | $985.45 |
| WisconsinWisconsin | — | $820.13 |
| West VirginiaWest Virginia | — | $899.88 |
| WyomingWyoming | — | $876.96 |
27416 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
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
How the 27416 rate is calculated
Each of 27416’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 · 27416
RVUs × geographic indexes × conversion factor
Work13.81
13.81 RVUs× 1.000 GPCI
Practice expense10.27
10.27 RVUs× 1.000 GPCI
Malpractice2.94
2.94 RVUs× 1.000 GPCI
Adjusted RVUs
27.0200
Conversion factor
$33.4009
Medicare rate
$902.49
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact New Mexico inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
2,881
- Code
- 27416
- Physician work
- 13.81
- Practice expense
- 10.27
- Malpractice
- 2.94
GPCI2026.csv
77
- Locality
- New Mexico
- Physician work
- 1.000
- Practice expense
- 0.917
- Malpractice
- 1.201
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 13.81 | × 1.000 | 13.8100 |
| Practice expense | 10.27 | × 0.917 | 9.4176 |
| Malpractice | 2.94 | × 1.201 | 3.5309 |
| Total RVUs | 26.7585 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, New Mexico$893.76
Facility: (13.81 × 1 + 10.27 × 0.917 + 2.94 × 1.201) × $33.4009 = $893.76
Payment rules and modifiers for 27416
27416 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 27416
Knee cartilage graft, autograft, open approach
| 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) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| 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 · 27416
Knee cartilage graft, autograft, open approach
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
27416 without 50 · national facility
$902.49
Knee cartilage graft, autograft, open approach
27416-50 · Bilateral: 150%
$1,353.74
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).
How 27416 has changed in New Mexico
27416 · Office / nonfacility
Rate unavailable
Effective 2026-10-01
A rate is unavailable in one of these releases, so a change cannot be calculated.
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
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $893.76 | RVU26D |
| 2026-07-01 | Not available in this setting | $893.76 | RVU26C |
| 2026-04-01 | Not available in this setting | $893.76 | RVU26B |
| 2026-01-01 | Not available in this setting | $893.76 | RVU26A |
| 2025-10-01 | Not available in this setting | $945.59 | RVU25D |
| 2025-07-01 | Not available in this setting | $945.59 | RVU25C |
| 2025-04-01 | Not available in this setting | $945.59 | RVU25B |
| 2025-01-01 | Not available in this setting | $945.59 | RVU25A |
| 2024-10-01 | Not available in this setting | $965.11 | RVU24D |
| 2024-07-01 | Not available in this setting | $965.11 | RVU24C |
| 2024-04-01 | Not available in this setting | $965.11 | RVU24B |
| 2024-03-09 | Not available in this setting | $965.11 | RVU24AR |
| 2024-01-01 | Not available in this setting | $949.36 | RVU24A |
| 2023-10-01 | Not available in this setting | $972.77 | RVU23D |
| 2023-07-01 | Not available in this setting | $972.77 | RVU23C |
| 2023-04-01 | Not available in this setting | $972.77 | RVU23B |
| 2023-01-01 | Not available in this setting | $972.77 | RVU23A |
| 2022-10-01 | Not available in this setting | $981.27 | RVU22D |
| 2022-07-01 | Not available in this setting | $981.27 | RVU22C |
| 2022-04-01 | Not available in this setting | $981.27 | RVU22B |
| 2022-01-01 | Not available in this setting | $981.27 | RVU22A |
| 2021-10-01 | Not available in this setting | $981.71 | RVU21D |
| 2021-07-01 | Not available in this setting | $981.71 | RVU21C |
| 2021-04-01 | Not available in this setting | $981.71 | RVU21B |
| 2021-01-01 | Not available in this setting | $981.71 | RVU21A |
| 2020-10-01 | Not available in this setting | $1,005.80 | RVU20D |
| 2020-07-01 | Not available in this setting | $1,005.80 | RVU20C |
| 2020-04-01 | Not available in this setting | $1,005.80 | RVU20B |
| 2020-01-01 | Not available in this setting | $1,005.80 | RVU20A |
| 2019-10-01 | Not available in this setting | $1,014.95 | RVU19D |
| 2019-07-01 | Not available in this setting | $1,014.95 | RVU19C |
| 2019-04-01 | Not available in this setting | $1,000.12 | RVU19B |
| 2019-01-01 | Not available in this setting | $1,000.12 | RVU19A |
| 2018-10-01 | Not available in this setting | $1,011.93 | RVU18D |
| 2018-07-01 | Not available in this setting | $1,011.93 | RVU18C |
| 2018-04-01 | Not available in this setting | $1,011.93 | RVU18B |
| 2018-01-01 | Not available in this setting | $1,011.93 | RVU18AR1 |
| 2017-10-01 | Not available in this setting | $1,002.96 | RVU17D |
| 2017-07-01 | Not available in this setting | $1,002.96 | RVU17C |
| 2017-04-01 | Not available in this setting | $1,002.96 | RVU17B |
| 2017-01-01 | Not available in this setting | $1,002.96 | RVU17A |
| 2016-10-01 | Not available in this setting | $992.58 | RVU16D |
| 2016-07-01 | Not available in this setting | $992.58 | RVU16C |
| 2016-04-01 | Not available in this setting | $992.58 | RVU16B |
| 2016-01-01 | Not available in this setting | $992.58 | RVU16A |
| 2015-10-01 | Not available in this setting | $1,001.50 | RVU15D |
| 2015-07-01 | Not available in this setting | $1,001.50 | RVU15C |
| 2015-04-01 | Not available in this setting | $996.52 | RVU15B |
| 2015-01-01 | Not available in this setting | $996.52 | RVU15A |
| 2014-10-01 | Not available in this setting | $976.80 | RVU14D |
| 2014-07-01 | Not available in this setting | $976.80 | RVU14C |
| 2014-04-01 | Not available in this setting | $976.80 | RVU14B |
| 2014-01-01 | Not available in this setting | $976.80 | RVU14A |
| 2013-10-01 | Not available in this setting | $952.88 | RVU13D |
| 2013-07-01 | Not available in this setting | $952.88 | RVU13C |
| 2013-04-01 | Not available in this setting | $952.88 | RVU13B |
| 2013-01-01 | Not available in this setting | $952.88 | RVU13AR |
Where the New Mexico rate applies
New Mexico is a Medicare payment area, not a city. Our Census mapping connects it to 528 cities and communities in New Mexico. Some span more than one payment area; confirm with the service ZIP.
- Abeytas
- Abiquiu
- Acomita Lake
- Adelino
- Agua Fria
- Alamillo
- Alamo
- Alamogordo
27416 billing questions
How does this differ from 27415?
This code is for osteochondral tissue harvested from the same patient. Code 27415 is the open procedure using donor osteochondral tissue.
How does this differ from 27412?
This code transfers osteochondral plugs, including bone, from the patient’s own knee. Code 27412 describes knee treatment using an autologous chondrocyte implant rather than transferred osteochondral plugs.
When is 29866 more appropriate?
Code 29866 describes arthroscopic osteochondral autografting. Use 27416 for the open approach when the documented procedure meets its service description.
What operative details support reporting?
Document the focal defect and its knee location, the open grafting technique, and the autologous harvest and recipient sites. Include laterality.
How is bilateral treatment reported?
For bilateral procedures, modifier 50 is paid at 150%. The 90-day global period applies to the surgery.
Can an assistant surgeon be reported?
Assistant-at-surgery payment is allowed only when medical necessity is documented. Co-surgeons and team surgery are 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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