CPT code 27428: Knee reconstruction, intra-articular ligament2026 Medicare rate & RVUs in Maryland
Report this procedure for surgical reconstruction of an intra-articular knee ligament, commonly a cruciate ligament, when reconstruction rather than direct repair is performed.
CMS doesn’t publish an office rate for 27428 in Maryland.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 sections
What 27428 covers
This service reconstructs a ligament within the knee joint, commonly a cruciate ligament, to restore stability when the ligament cannot be adequately treated with direct repair. An orthopedic surgeon performs the reconstruction in an operating room, typically using a graft to replace or augment the deficient ligament. The operative report should identify the ligament treated, the intra-articular reconstruction performed, and the reason reconstruction was selected.
Report 27428 for the intra-articular portion of the reconstruction; use the related code for an extra-articular reconstruction or for a procedure combining both locations. The day-before preoperative visit and 90 days of related postoperative care are included in the major-surgery global period. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and others at 50%. Modifier 50 identifies a bilateral procedure, 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 27428 pays more and less in Maryland
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Baltimore area, MD | Unavailable | $1,105.16 |
| Rest of Maryland | Unavailable | $1,041.77 |
| Washington, DC area | Unavailable | $1,155.71 |
How the 27428 rate is calculated
Each of 27428’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 · 27428
RVUs × geographic indexes × conversion factor
Work15.19
15.19 RVUs× 1.000 GPCI
Practice expense12.73
12.73 RVUs× 1.000 GPCI
Malpractice3.23
3.23 RVUs× 1.000 GPCI
Adjusted RVUs
31.1500
Conversion factor
$33.4009
Medicare rate
$1,040.44
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 27428
27428 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 27428
Knee reconstruction, intra-articular ligament
| 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 · 27428
Knee reconstruction, intra-articular ligament
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
27428 without 50 · national facility
$1,040.44
Knee reconstruction, intra-articular ligament
27428-50 · Bilateral: 150%
$1,560.66
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).
27428 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 27427Knee reconstructionExtra-articular ligament
- 27427 is for extra-articular knee ligament reconstruction. 27428 applies when the reconstruction is intra-articular.
- 27429Knee reconstructionIntra- and extra-articular
- 27429 describes reconstruction involving both intra-articular and extra-articular work; 27428 describes the intra-articular reconstruction.
- 27407Cruciate ligament repairPrimary knee repair
- 27407 is for knee ligament repair. Choose 27428 when the documented procedure reconstructs an intra-articular ligament instead.
- 29888ACL surgeryArthroscopically assisted
- 29888 is for arthroscopically aided ACL repair, augmentation, or reconstruction. 27428 describes intra-articular knee ligament reconstruction outside that arthroscopically aided ACL code.
27428 billing questions
How is 27428 distinguished from 27427 and 27429?
Use 27428 for an intra-articular ligament reconstruction. Code 27427 describes an extra-articular reconstruction, while 27429 describes reconstruction involving both intra-articular and extra-articular work.
When is reconstruction reported instead of 27407?
Code 27428 describes intra-articular reconstruction, commonly involving a graft. Code 27407 is for repair of a knee ligament, rather than this intra-articular reconstruction.
What documentation supports 27428?
The operative report should identify the ligament reconstructed, document the intra-articular work, and explain the reconstruction performed. It should distinguish that work from direct ligament repair or an extra-articular procedure.
Does the 90-day global period include postoperative visits?
Yes. The major-surgery global period includes the day-before preoperative visit and 90 days of related postoperative care.
How are bilateral procedures and additional same-session procedures handled?
Modifier 50 identifies a bilateral procedure, which is paid at 150%. For multiple procedures in one session, the highest-valued procedure is paid in full and the others at 50%.
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
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