CPT code 27427: Knee reconstruction, extra-articular ligament2026 Medicare rate & RVUs

Medicare pays $662.67 for 27427 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 27427 covers

An orthopedic surgeon uses this service to rebuild or augment a ligament outside the knee joint, restoring stability when the ligament cannot be managed with a primary repair alone. The operation is typically performed in a hospital or ambulatory surgery center for traumatic or chronic knee instability; the operative report should identify the reconstructed ligament and establish that the work is extra-articular.

Choose this code for extra-articular reconstruction, not reconstruction within the joint or a combined intra- and extra-articular procedure. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Bilateral reporting with modifier 50 is paid at 150%. An assistant at surgery may be paid; co-surgeons are paid only with 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 27427 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

27427 rates by state

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

How the 27427 rate is calculated

Each of 27427’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 27427

27427 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

27427 compared with similar codes

How to choose

27428Knee reconstructionIntra-articular ligament

Use 27428 when the reconstructed ligament work is intra-articular. This code is for extra-articular reconstruction.

27429Knee reconstructionIntra- and extra-articular

Use 27429 when the operation reconstructs both intra-articular and extra-articular structures; use this code for extra-articular reconstruction alone.

27405Knee ligament repairPrimary collateral repair

Code 27405 is for primary repair of a torn knee ligament. This code represents reconstruction or augmentation of an extra-articular ligament.

Codes related to 27427

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