CPT code 27422: Patellar reconstruction, with extensor realignment2026 Medicare rate & RVUs in Arizona
Reports operative reconstruction for a dislocating kneecap when treatment includes extensor-mechanism realignment, muscle advancement, or imbrication.
In Arizona, Medicare pays $679.54 for 27422 in a facility. There’s no office rate.
Check a contract rate as a % of Medicare · 27422 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 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.
How Arizona compares for 27422
Across 109 of 109 payment localities, the facility rate for 27422 runs from $623.18 in Arkansas to $853.02 in Alaska. Arizona pays $679.54. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Arizona · this page$679.54
- Los Angeles, CA · California$743.37+$63.83
- Washington, DC area · District of Columbia$777.40+$97.86
- Miami, FL · Florida$817.15+$137.61
- Chicago, IL · Illinois$792.53+$112.99
- Manhattan, NY · New York$808.83+$129.29
- Alaska · Alaska$853.02+$173.48
Other areas in Arizona first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | — | $631.48 |
| ArkansasArkansas | — | $623.18 |
| Bakersfield, CACalifornia | — | $706.40 |
| Chico, CACalifornia | — | $700.67 |
| El Centro, CACalifornia | — | $701.01 |
| Fresno, CACalifornia | — | $700.67 |
| Hanford, CACalifornia | — | $700.67 |
| Madera, CACalifornia | — | $700.67 |
| Merced, CACalifornia | — | $700.67 |
| Modesto, CACalifornia | — | $700.67 |
| Napa, CACalifornia | — | $779.93 |
| Oxnard, CACalifornia | — | $735.90 |
| Redding, CACalifornia | — | $700.67 |
| Rest of CaliforniaCalifornia | — | $700.67 |
| Riverside, CACalifornia | — | $723.02 |
| Sacramento, CACalifornia | — | $726.88 |
| Salinas, CACalifornia | — | $724.03 |
| San Diego, CACalifornia | — | $735.10 |
| Marin County, CACalifornia | — | $814.48 |
| San Francisco, CACalifornia | — | $812.11 |
| San Benito County, CACalifornia | — | $834.31 |
| Santa Clara County, CACalifornia | — | $824.66 |
| San Luis Obispo, CACalifornia | — | $713.43 |
| Santa Cruz, CACalifornia | — | $737.33 |
| Santa Maria, CACalifornia | — | $725.11 |
| Santa Rosa, CACalifornia | — | $744.18 |
| Stockton, CACalifornia | — | $700.67 |
| Vallejo, CACalifornia | — | $776.52 |
| Visalia, CACalifornia | — | $700.67 |
| Yuba City, CACalifornia | — | $700.67 |
| ColoradoColorado | — | $706.52 |
| ConnecticutConnecticut | — | $742.85 |
| DelawareDelaware | — | $689.83 |
| Fort Lauderdale, FLFlorida | — | $758.74 |
| Rest of FloridaFlorida | — | $720.63 |
| Atlanta, GAGeorgia | — | $718.46 |
| Rest of GeorgiaGeorgia | — | $680.02 |
| Hawaii, Guam, HIHawaii | — | $710.18 |
| IowaIowa | — | $631.61 |
| IdahoIdaho | — | $638.38 |
| East St. Louis, ILIllinois | — | $745.44 |
| Rest of IllinoisIllinois | — | $712.03 |
| Suburban Chicago, ILIllinois | — | $762.72 |
| IndianaIndiana | — | $641.36 |
| KansasKansas | — | $635.78 |
| KentuckyKentucky | — | $659.88 |
| New Orleans, LALouisiana | — | $690.68 |
| Rest of LouisianaLouisiana | — | $661.68 |
| Metropolitan Boston, MAMassachusetts | — | $762.34 |
| Rest of MassachusettsMassachusetts | — | $705.70 |
| Baltimore area, MDMaryland | — | $742.21 |
| Rest of MarylandMaryland | — | $699.94 |
| Rest of MaineMaine | — | $648.73 |
| Southern Maine, MEMaine | — | $670.44 |
| Detroit, MIMichigan | — | $736.01 |
| Rest of MichiganMichigan | — | $681.88 |
| MinnesotaMinnesota | — | $658.45 |
| Metropolitan Kansas City, MOMissouri | — | $679.04 |
| Metropolitan St. Louis, MOMissouri | — | $684.63 |
| Rest of MissouriMissouri | — | $655.96 |
| MississippiMississippi | — | $639.34 |
| MontanaMontana | — | $698.61 |
| North CarolinaNorth Carolina | — | $653.77 |
| North DakotaNorth Dakota | — | $657.48 |
| NebraskaNebraska | — | $632.67 |
| New HampshireNew Hampshire | — | $702.24 |
| Northern New JerseyNew Jersey | — | $771.92 |
| Rest of New JerseyNew Jersey | — | $746.10 |
| New MexicoNew Mexico | — | $688.07 |
| NevadaNevada | — | $687.44 |
| NYC suburbs and Long Island, NYNew York | — | $835.68 |
| Poughkeepsie and northern NYC suburbs, NYNew York | — | $756.50 |
| Queens, NYNew York | — | $804.77 |
| Rest of New YorkNew York | — | $663.27 |
| OhioOhio | — | $673.47 |
| OklahomaOklahoma | — | $651.48 |
| Portland, OROregon | — | $719.24 |
| Rest of OregonOregon | — | $676.93 |
| Metropolitan Philadelphia, PAPennsylvania | — | $730.31 |
| Rest of PennsylvaniaPennsylvania | — | $670.58 |
| Puerto RicoPuerto Rico | — | $700.97 |
| Rhode IslandRhode Island | — | $707.36 |
| South CarolinaSouth Carolina | — | $665.76 |
| South DakotaSouth Dakota | — | $652.62 |
| TennesseeTennessee | — | $639.56 |
| Austin, TXTexas | — | $708.71 |
| Beaumont, TXTexas | — | $667.09 |
| Brazoria, TXTexas | — | $683.45 |
| Dallas, TXTexas | — | $690.68 |
| Fort Worth, TXTexas | — | $688.62 |
| Galveston, TXTexas | — | $687.38 |
| Houston, TXTexas | — | $725.45 |
| Rest of TexasTexas | — | $676.86 |
| UtahUtah | — | $673.84 |
| VirginiaVirginia | — | $673.27 |
| Virgin Islands, VIUnited States Virgin Islands | — | $700.97 |
| VermontVermont | — | $661.46 |
| Rest of WashingtonWashington | — | $702.20 |
| King County, WAWashington | — | $770.05 |
| WisconsinWisconsin | — | $638.20 |
| West VirginiaWest Virginia | — | $689.79 |
| WyomingWyoming | — | $680.68 |
27422 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 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.
How the rate is built · 27422
RVUs × geographic indexes × conversion factor
Work9.95
9.95 RVUs× 1.000 GPCI
Practice expense8.89
8.89 RVUs× 1.000 GPCI
Malpractice2.08
2.08 RVUs× 1.000 GPCI
Adjusted RVUs
20.9200
Conversion factor
$33.4009
Medicare rate
$698.75
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Arizona inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
2,884
- Code
- 27422
- Physician work
- 9.95
- Practice expense
- 8.89
- Malpractice
- 2.08
GPCI2026.csv
6
- Locality
- Arizona
- Physician work
- 1.000
- Practice expense
- 0.969
- Malpractice
- 0.856
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 9.95 | × 1.000 | 9.9500 |
| Practice expense | 8.89 | × 0.969 | 8.6144 |
| Malpractice | 2.08 | × 0.856 | 1.7805 |
| Total RVUs | 20.3449 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Arizona$679.54
Facility: (9.95 × 1 + 8.89 × 0.969 + 2.08 × 0.856) × $33.4009 = $679.54
Payment rules and modifiers for 27422
27422 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 27422
Patellar reconstruction, with extensor realignment
| 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) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| 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 · 27422
Patellar reconstruction, with extensor realignment
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
27422 without 50 · national facility
$698.75
Patellar reconstruction, with extensor realignment
27422-50 · Bilateral: 150%
$1,048.13
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 27422 has changed in Arizona
27422 · 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 | $679.54 | RVU26D |
| 2026-07-01 | Not available in this setting | $679.54 | RVU26C |
| 2026-04-01 | Not available in this setting | $679.54 | RVU26B |
| 2026-01-01 | Not available in this setting | $679.54 | RVU26A |
| 2025-10-01 | Not available in this setting | $719.57 | RVU25D |
| 2025-07-01 | Not available in this setting | $719.57 | RVU25C |
| 2025-04-01 | Not available in this setting | $719.57 | RVU25B |
| 2025-01-01 | Not available in this setting | $719.57 | RVU25A |
| 2024-10-01 | Not available in this setting | $732.39 | RVU24D |
| 2024-07-01 | Not available in this setting | $732.39 | RVU24C |
| 2024-04-01 | Not available in this setting | $732.39 | RVU24B |
| 2024-03-09 | Not available in this setting | $732.39 | RVU24AR |
| 2024-01-01 | Not available in this setting | $720.44 | RVU24A |
| 2023-10-01 | Not available in this setting | $735.45 | RVU23D |
| 2023-07-01 | Not available in this setting | $735.45 | RVU23C |
| 2023-04-01 | Not available in this setting | $735.45 | RVU23B |
| 2023-01-01 | Not available in this setting | $735.45 | RVU23A |
| 2022-10-01 | Not available in this setting | $738.66 | RVU22D |
| 2022-07-01 | Not available in this setting | $738.66 | RVU22C |
| 2022-04-01 | Not available in this setting | $738.66 | RVU22B |
| 2022-01-01 | Not available in this setting | $738.66 | RVU22A |
| 2021-10-01 | Not available in this setting | $740.63 | RVU21D |
| 2021-07-01 | Not available in this setting | $740.63 | RVU21C |
| 2021-04-01 | Not available in this setting | $740.63 | RVU21B |
| 2021-01-01 | Not available in this setting | $740.63 | RVU21A |
| 2020-10-01 | Not available in this setting | $751.08 | RVU20D |
| 2020-07-01 | Not available in this setting | $751.08 | RVU20C |
| 2020-04-01 | Not available in this setting | $751.08 | RVU20B |
| 2020-01-01 | Not available in this setting | $751.08 | RVU20A |
| 2019-10-01 | Not available in this setting | $749.32 | RVU19D |
| 2019-07-01 | Not available in this setting | $749.32 | RVU19C |
| 2019-04-01 | Not available in this setting | $749.32 | RVU19B |
| 2019-01-01 | Not available in this setting | $749.32 | RVU19A |
| 2018-10-01 | Not available in this setting | $747.50 | RVU18D |
| 2018-07-01 | Not available in this setting | $747.50 | RVU18C |
| 2018-04-01 | Not available in this setting | $747.50 | RVU18B |
| 2018-01-01 | Not available in this setting | $747.50 | RVU18AR1 |
| 2017-10-01 | Not available in this setting | $750.59 | RVU17D |
| 2017-07-01 | Not available in this setting | $750.59 | RVU17C |
| 2017-04-01 | Not available in this setting | $750.59 | RVU17B |
| 2017-01-01 | Not available in this setting | $750.59 | RVU17A |
| 2016-10-01 | Not available in this setting | $754.14 | RVU16D |
| 2016-07-01 | Not available in this setting | $754.14 | RVU16C |
| 2016-04-01 | Not available in this setting | $754.14 | RVU16B |
| 2016-01-01 | Not available in this setting | $754.14 | RVU16A |
| 2015-10-01 | Not available in this setting | $759.29 | RVU15D |
| 2015-07-01 | Not available in this setting | $759.29 | RVU15C |
| 2015-04-01 | Not available in this setting | $755.51 | RVU15B |
| 2015-01-01 | Not available in this setting | $755.51 | RVU15A |
| 2014-10-01 | Not available in this setting | $752.19 | RVU14D |
| 2014-07-01 | Not available in this setting | $752.19 | RVU14C |
| 2014-04-01 | Not available in this setting | $752.19 | RVU14B |
| 2014-01-01 | Not available in this setting | $752.19 | RVU14A |
| 2013-10-01 | Not available in this setting | $745.51 | RVU13D |
| 2013-07-01 | Not available in this setting | $745.51 | RVU13C |
| 2013-04-01 | Not available in this setting | $745.51 | RVU13B |
| 2013-01-01 | Not available in this setting | $745.51 | RVU13AR |
Where the Arizona rate applies
Arizona is a Medicare payment area, not a city. Our Census mapping connects it to 467 cities and communities in Arizona. Some span more than one payment area; confirm with the service ZIP.
- Aguila
- Ajo
- Ak Chin
- Ak-Chin Village
- Alamo Lake
- Ali Chuk
- Ali Chukson
- Ali Molina
27422 billing questions
How does this differ from 27420?
Use 27422 when the reconstruction includes extensor-mechanism realignment, muscle advancement, or imbrication. Code 27420 is the related reconstruction without those added elements.
What should the operative report support?
Document patellar instability, the side treated, and the reconstruction performed, including any extensor realignment, muscle advancement, or imbrication.
How is bilateral surgery reported?
Report bilateral treatment with modifier 50. CMS lists bilateral payment at 150%.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be paid?
Assistant-at-surgery payment may be made. Co-surgeons are paid only with supporting documentation; 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
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