CPT code 27428: Knee reconstruction, intra-articular ligament2026 Medicare rate & RVUs in North Carolina
Report this procedure for surgical reconstruction of an intra-articular knee ligament, commonly a cruciate ligament, when reconstruction rather than direct repair is performed.
In North Carolina, Medicare pays $973.00 for 27428 in a facility. There’s no office rate.
Check a contract rate as a % of Medicare · 27428 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 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.
How North Carolina compares for 27428
Across 109 of 109 payment localities, the facility rate for 27428 runs from $928.16 in Arkansas to $1,273.32 in Alaska. North Carolina pays $973.00. The RVUs are the same everywhere; the geographic indexes change the dollars.
- North Carolina · this page$973.00
- Los Angeles, CA · California$1,102.80+$129.80
- Washington, DC area · District of Columbia$1,155.71+$182.71
- Miami, FL · Florida$1,222.83+$249.83
- Chicago, IL · Illinois$1,185.83+$212.83
- Manhattan, NY · New York$1,205.01+$232.01
- Alaska · Alaska$1,273.32+$300.32
Other areas in North Carolina first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | — | $940.47 |
| ArkansasArkansas | — | $928.16 |
| ArizonaArizona | — | $1,011.72 |
| Bakersfield, CACalifornia | — | $1,048.71 |
| Chico, CACalifornia | — | $1,039.82 |
| El Centro, CACalifornia | — | $1,040.36 |
| Fresno, CACalifornia | — | $1,039.82 |
| Hanford, CACalifornia | — | $1,039.82 |
| Madera, CACalifornia | — | $1,039.82 |
| Merced, CACalifornia | — | $1,039.82 |
| Modesto, CACalifornia | — | $1,039.82 |
| Napa, CACalifornia | — | $1,154.53 |
| Oxnard, CACalifornia | — | $1,091.36 |
| Redding, CACalifornia | — | $1,039.82 |
| Rest of CaliforniaCalifornia | — | $1,039.82 |
| Riverside, CACalifornia | — | $1,074.53 |
| Sacramento, CACalifornia | — | $1,077.95 |
| Salinas, CACalifornia | — | $1,073.71 |
| San Diego, CACalifornia | — | $1,089.59 |
| Marin County, CACalifornia | — | $1,204.60 |
| San Francisco, CACalifornia | — | $1,200.93 |
| San Benito County, CACalifornia | — | $1,234.12 |
| Santa Clara County, CACalifornia | — | $1,219.13 |
| San Luis Obispo, CACalifornia | — | $1,058.11 |
| Santa Cruz, CACalifornia | — | $1,092.45 |
| Santa Maria, CACalifornia | — | $1,075.17 |
| Santa Rosa, CACalifornia | — | $1,102.54 |
| Stockton, CACalifornia | — | $1,039.82 |
| Vallejo, CACalifornia | — | $1,149.25 |
| Visalia, CACalifornia | — | $1,039.82 |
| Yuba City, CACalifornia | — | $1,039.82 |
| ColoradoColorado | — | $1,050.11 |
| ConnecticutConnecticut | — | $1,105.98 |
| DelawareDelaware | — | $1,026.98 |
| Fort Lauderdale, FLFlorida | — | $1,133.14 |
| Rest of FloridaFlorida | — | $1,076.00 |
| Atlanta, GAGeorgia | — | $1,070.45 |
| Rest of GeorgiaGeorgia | — | $1,015.23 |
| Hawaii, Guam, HIHawaii | — | $1,053.27 |
| IowaIowa | — | $939.24 |
| IdahoIdaho | — | $949.57 |
| East St. Louis, ILIllinois | — | $1,115.82 |
| Rest of IllinoisIllinois | — | $1,064.19 |
| Suburban Chicago, ILIllinois | — | $1,138.76 |
| IndianaIndiana | — | $953.95 |
| KansasKansas | — | $946.11 |
| KentuckyKentucky | — | $984.07 |
| New Orleans, LALouisiana | — | $1,030.02 |
| Rest of LouisianaLouisiana | — | $987.01 |
| Metropolitan Boston, MAMassachusetts | — | $1,131.86 |
| Rest of MassachusettsMassachusetts | — | $1,049.19 |
| Baltimore area, MDMaryland | — | $1,105.16 |
| Rest of MarylandMaryland | — | $1,041.77 |
| Rest of MaineMaine | — | $965.64 |
| Southern Maine, MEMaine | — | $996.80 |
| Detroit, MIMichigan | — | $1,099.57 |
| Rest of MichiganMichigan | — | $1,017.36 |
| MinnesotaMinnesota | — | $976.82 |
| Metropolitan Kansas City, MOMissouri | — | $1,012.02 |
| Metropolitan St. Louis, MOMissouri | — | $1,020.24 |
| Rest of MissouriMissouri | — | $978.96 |
| MississippiMississippi | — | $953.18 |
| MontanaMontana | — | $1,040.22 |
| North DakotaNorth Dakota | — | $976.35 |
| NebraskaNebraska | — | $940.59 |
| New HampshireNew Hampshire | — | $1,044.39 |
| Northern New JerseyNew Jersey | — | $1,147.77 |
| Rest of New JerseyNew Jersey | — | $1,110.32 |
| New MexicoNew Mexico | — | $1,026.83 |
| NevadaNevada | — | $1,022.85 |
| NYC suburbs and Long Island, NYNew York | — | $1,245.73 |
| Poughkeepsie and northern NYC suburbs, NYNew York | — | $1,126.32 |
| Queens, NYNew York | — | $1,197.98 |
| Rest of New YorkNew York | — | $987.14 |
| OhioOhio | — | $1,004.31 |
| OklahomaOklahoma | — | $970.88 |
| Portland, OROregon | — | $1,068.13 |
| Rest of OregonOregon | — | $1,006.70 |
| Metropolitan Philadelphia, PAPennsylvania | — | $1,087.83 |
| Rest of PennsylvaniaPennsylvania | — | $999.64 |
| Puerto RicoPuerto Rico | — | $1,043.50 |
| Rhode IslandRhode Island | — | $1,052.46 |
| South CarolinaSouth Carolina | — | $991.94 |
| South DakotaSouth Dakota | — | $968.80 |
| TennesseeTennessee | — | $951.79 |
| Austin, TXTexas | — | $1,053.82 |
| Beaumont, TXTexas | — | $994.51 |
| Brazoria, TXTexas | — | $1,016.94 |
| Dallas, TXTexas | — | $1,027.98 |
| Fort Worth, TXTexas | — | $1,025.13 |
| Galveston, TXTexas | — | $1,022.96 |
| Houston, TXTexas | — | $1,082.09 |
| Rest of TexasTexas | — | $1,008.29 |
| UtahUtah | — | $1,003.92 |
| VirginiaVirginia | — | $1,001.49 |
| Virgin Islands, VIUnited States Virgin Islands | — | $1,043.50 |
| VermontVermont | — | $982.89 |
| Rest of WashingtonWashington | — | $1,043.78 |
| King County, WAWashington | — | $1,142.58 |
| WisconsinWisconsin | — | $947.92 |
| West VirginiaWest Virginia | — | $1,031.24 |
| WyomingWyoming | — | $1,012.39 |
27428 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 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.
The exact North Carolina inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
2,888
- Code
- 27428
- Physician work
- 15.19
- Practice expense
- 12.73
- Malpractice
- 3.23
GPCI2026.csv
83
- Locality
- North Carolina
- Physician work
- 1.000
- Practice expense
- 0.933
- Malpractice
- 0.639
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 15.19 | × 1.000 | 15.1900 |
| Practice expense | 12.73 | × 0.933 | 11.8771 |
| Malpractice | 3.23 | × 0.639 | 2.0640 |
| Total RVUs | 29.1311 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, North Carolina$973.00
Facility: (15.19 × 1 + 12.73 × 0.933 + 3.23 × 0.639) × $33.4009 = $973.00
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).
How 27428 has changed in North Carolina
27428 · 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 | $973.00 | RVU26D |
| 2026-07-01 | Not available in this setting | $973.00 | RVU26C |
| 2026-04-01 | Not available in this setting | $973.00 | RVU26B |
| 2026-01-01 | Not available in this setting | $973.00 | RVU26A |
| 2025-10-01 | Not available in this setting | $1,033.12 | RVU25D |
| 2025-07-01 | Not available in this setting | $1,033.12 | RVU25C |
| 2025-04-01 | Not available in this setting | $1,033.12 | RVU25B |
| 2025-01-01 | Not available in this setting | $1,033.12 | RVU25A |
| 2024-10-01 | Not available in this setting | $1,053.58 | RVU24D |
| 2024-07-01 | Not available in this setting | $1,053.58 | RVU24C |
| 2024-04-01 | Not available in this setting | $1,053.58 | RVU24B |
| 2024-03-09 | Not available in this setting | $1,053.58 | RVU24AR |
| 2024-01-01 | Not available in this setting | $1,036.39 | RVU24A |
| 2023-10-01 | Not available in this setting | $1,072.53 | RVU23D |
| 2023-07-01 | Not available in this setting | $1,072.53 | RVU23C |
| 2023-04-01 | Not available in this setting | $1,072.53 | RVU23B |
| 2023-01-01 | Not available in this setting | $1,072.53 | RVU23A |
| 2022-10-01 | Not available in this setting | $1,091.88 | RVU22D |
| 2022-07-01 | Not available in this setting | $1,091.88 | RVU22C |
| 2022-04-01 | Not available in this setting | $1,091.88 | RVU22B |
| 2022-01-01 | Not available in this setting | $1,091.88 | RVU22A |
| 2021-10-01 | Not available in this setting | $1,093.61 | RVU21D |
| 2021-07-01 | Not available in this setting | $1,093.61 | RVU21C |
| 2021-04-01 | Not available in this setting | $1,093.61 | RVU21B |
| 2021-01-01 | Not available in this setting | $1,093.61 | RVU21A |
| 2020-10-01 | Not available in this setting | $1,100.81 | RVU20D |
| 2020-07-01 | Not available in this setting | $1,100.81 | RVU20C |
| 2020-04-01 | Not available in this setting | $1,100.81 | RVU20B |
| 2020-01-01 | Not available in this setting | $1,100.81 | RVU20A |
| 2019-10-01 | Not available in this setting | $1,092.25 | RVU19D |
| 2019-07-01 | Not available in this setting | $1,092.25 | RVU19C |
| 2019-04-01 | Not available in this setting | $1,089.24 | RVU19B |
| 2019-01-01 | Not available in this setting | $1,089.24 | RVU19A |
| 2018-10-01 | Not available in this setting | $1,091.22 | RVU18D |
| 2018-07-01 | Not available in this setting | $1,091.22 | RVU18C |
| 2018-04-01 | Not available in this setting | $1,091.22 | RVU18B |
| 2018-01-01 | Not available in this setting | $1,091.22 | RVU18AR1 |
| 2017-10-01 | Not available in this setting | $1,085.02 | RVU17D |
| 2017-07-01 | Not available in this setting | $1,085.02 | RVU17C |
| 2017-04-01 | Not available in this setting | $1,085.02 | RVU17B |
| 2017-01-01 | Not available in this setting | $1,085.02 | RVU17A |
| 2016-10-01 | Not available in this setting | $1,088.21 | RVU16D |
| 2016-07-01 | Not available in this setting | $1,088.21 | RVU16C |
| 2016-04-01 | Not available in this setting | $1,088.21 | RVU16B |
| 2016-01-01 | Not available in this setting | $1,088.21 | RVU16A |
| 2015-10-01 | Not available in this setting | $1,094.88 | RVU15D |
| 2015-07-01 | Not available in this setting | $1,094.88 | RVU15C |
| 2015-04-01 | Not available in this setting | $1,089.43 | RVU15B |
| 2015-01-01 | Not available in this setting | $1,089.43 | RVU15A |
| 2014-10-01 | Not available in this setting | $1,076.02 | RVU14D |
| 2014-07-01 | Not available in this setting | $1,076.02 | RVU14C |
| 2014-04-01 | Not available in this setting | $1,076.02 | RVU14B |
| 2014-01-01 | Not available in this setting | $1,076.02 | RVU14A |
| 2013-10-01 | Not available in this setting | $1,057.31 | RVU13D |
| 2013-07-01 | Not available in this setting | $1,057.31 | RVU13C |
| 2013-04-01 | Not available in this setting | $1,057.31 | RVU13B |
| 2013-01-01 | Not available in this setting | $1,057.31 | RVU13AR |
Where the North Carolina rate applies
North Carolina is a Medicare payment area, not a city. Our Census mapping connects it to 785 cities and communities in North Carolina. Some span more than one payment area; confirm with the service ZIP.
- Aberdeen
- Advance
- Ahoskie
- Alamance
- Albemarle
- Alexis
- Alliance
- Altamahaw
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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