CPT code 27424: Patella surgery, removal or revision2026 Medicare rate & RVUs

Report 27424 when an orthopedic surgeon surgically removes or revises the kneecap, rather than reconstructing it for instability or resurfacing it with an implant.

CMS RVU26DEffective Oct 1, 2026109 payment localities34 Medicare services in 2024

Medicare pays $704.09 for 27424 nationally in a facility.

Medicare rate · 27424

Patella surgery, removal or revision

Office or facility?

Work RVUs
9.98
Total RVUs
21.08
Global days
090

National rate · 2026

$704.09

Facility setting, before claim adjustments.

See every locality for 27424 →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 27424 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 27424 covers

This code represents an operation to remove or revise the patella. Orthopedic surgeons typically perform it in a hospital or ambulatory surgical setting when the kneecap itself requires operative treatment, such as after significant damage or a prior patellar procedure. The operative report should make clear what was done to the patella and why; a procedure aimed at correcting patellar instability or resurfacing the patella is a different service.

Report 27424 for the patellar removal or revision actually performed, supported by the preoperative findings and operative details. CMS assigns a 90-day global period: the day-before preoperative visit and related postoperative care during the following 90 days are included. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. For bilateral surgery, modifier 50 is paid at 150%. 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 27424 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

27424 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$635.76
AlaskaUnavailable$858.29
ArizonaUnavailable$684.56
ArkansasUnavailable$627.34
Atlanta, GAUnavailable$724.18
Austin, TXUnavailable$714.02
Bakersfield, CAUnavailable$711.37
Baltimore area, MDUnavailable$748.16
Beaumont, TXUnavailable$672.08
Brazoria, TXUnavailable$688.41

27424 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.

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27424 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 27424 rate is calculated

Each of 27424’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 · 27424

RVUs × geographic indexes × conversion factor

Office or facility?

Work9.98

9.98 RVUs× 1.000 GPCI

Practice expense8.97

8.97 RVUs× 1.000 GPCI

Malpractice2.13

2.13 RVUs× 1.000 GPCI

Adjusted RVUs

21.0800

Conversion factor

$33.4009

Medicare rate

$704.09

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

Payment rules and modifiers for 27424

27424 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 27424

Patella surgery, removal or revision

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 · 27424

Patella surgery, removal or revision

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

27424 without 50 · national facility

$704.09

Patella surgery, removal or revision

27424-50 · Bilateral: 150%

$1,056.14

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

27424 compared with similar codes

Compare codes · National

5 codes, side by side

Office or facility?

  • 27424

    Patella surgery, removal or revision9.98 wRVU

    Not priced

  • 27420

    Patellar reconstruction, without extensor realignment10 wRVU

    Not priced

  • 27422

    Patellar reconstruction, with extensor realignment9.95 wRVU

    Not priced

  • 27437

    Patellar arthroplasty, without prosthesis8.71 wRVU

    Not priced

  • 27438

    Patellar arthroplasty, with prosthesis11.59 wRVU

    Not priced

How to choose

27420Patellar reconstructionWithout extensor realignment
Choose 27420 for reconstruction to address a dislocating patella. Choose 27424 when the operation removes or revises the patella itself.
27422Patellar reconstructionWith extensor realignment
Code 27422 describes instability reconstruction that includes extensor realignment or muscle advancement; 27424 describes removal or revision of the kneecap.
27437Patellar arthroplastyWithout prosthesis
Code 27437 is patellar arthroplasty without a prosthesis. It is not the code for removal or revision of the patella.
27438Patellar arthroplastyWith prosthesis
Code 27438 covers patellar arthroplasty with a prosthetic implant; 27424 covers removal or revision rather than implant-based resurfacing.

27424 billing questions

How is 27424 different from patellar instability reconstruction?

Use 27424 when the operation removes or revises the patella itself. Codes 27420 and 27422 describe reconstruction directed at a dislocating patella.

Is this the code for patellar resurfacing with an implant?

No. Code 27438 describes patellar arthroplasty with a prosthetic implant; 27424 is for removal or revision of the patella.

What postoperative care is included?

The 90-day global period includes the day-before preoperative visit and related postoperative care during the 90 days after surgery.

Can an assistant or co-surgeon be reported?

An assistant at surgery may be paid. Co-surgeons are paid only when supporting documentation is provided; team surgery is not permitted.

How is bilateral surgery handled?

CMS pays bilateral surgery reported with modifier 50 at 150%.

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 27424PPRRVU2026_Oct_nonQPP.csv, line 2,885 (RVU26D)

Open CMS sourceHow we calculate rates

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