CPT code 27422: Patellar reconstruction, with extensor realignment2026 Medicare rate & RVUs

Medicare pays $698.75 for 27422 nationally in a facility.

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

What 27422 covers

An orthopedic surgeon uses this service to surgically address recurrent patellar instability, such as a kneecap that repeatedly slips out of position. The reconstruction includes realignment of the extensor mechanism, muscle advancement, or imbrication as part of stabilizing the patella. It is typically performed in a hospital or ambulatory surgery setting; CMS recorded these services in facility settings in 2024.

Choose this code when the operative report supports the instability reconstruction and the added realignment or muscle work, rather than a soft-tissue reconstruction without those elements. Document the affected knee, the instability being treated, and the structures and techniques used. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in the same session, the highest-valued procedure is paid in full and others at 50%. Bilateral reporting with modifier 50 is paid at 150%. An assistant at surgery may be paid; co-surgeon payment requires 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 27422 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

27422 rates by state

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

How the 27422 rate is calculated

Each of 27422’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.

Payment rules and modifiers for 27422

27422 has a 90-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 50

27422 compared with similar codes

How to choose

27420Patellar reconstructionWithout extensor realignment

Both address a dislocating patella. Choose 27422 when the operative reconstruction includes extensor realignment, muscle advancement, or imbrication; 27420 represents the related reconstruction without those elements.

27418TubercleplastyAnterior tibial tubercle advancement

This code concerns anterior tibial tubercle reconstruction. Code 27422 is for patellar-instability reconstruction with extensor realignment or muscle work.

27425Patellar releaseOpen lateral retinacular release

Code 27425 represents open lateral retinacular release. It is not the broader patellar-instability reconstruction with extensor realignment reported under 27422.

Codes related to 27422

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

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

Open CMS sourceHow we calculate rates