CPT code 27438: Patellar arthroplasty, with prosthesis2026 Medicare rate & RVUs in Puerto Rico

In Puerto Rico, Medicare pays $784.15 for 27438 in a facility. There’s no office rate.

Check a contract rate as a % of Medicare · 27438 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 27438 covers

An orthopedic surgeon replaces or resurfaces the joint-facing surface of the patella with a prosthetic implant. The procedure addresses patellar joint damage when the operative plan is for patellar arthroplasty, rather than replacement of the full knee joint. It is performed in an operating room, typically in a hospital or ambulatory surgery center. The operative report should identify the patellar procedure and the use of a prosthetic component.

Report this code for the patellar arthroplasty itself; patellar resurfacing performed as part of a total knee arthroplasty is included in that broader procedure. The service has 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%. When performed bilaterally with modifier 50, payment is at 150%. Assistant-at-surgery payment may be available; 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 Puerto Rico compares for 27438

Across 109 of 109 payment localities, the facility rate for 27438 runs from $698.33 in Arkansas to $959.42 in Alaska. Puerto Rico pays $784.15. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

27438 rates by state

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

See 27438 in every payment locality

How the 27438 rate is calculated

Each of 27438’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 27438

27438 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

Codes related to 27438

Related codes aren’t interchangeable: bill the code that matches the service performed.

How 27438 has changed in Puerto Rico

Price 27438 for an earlier date of service

Where the Puerto Rico rate applies

Puerto Rico is a Medicare payment area, not a city. Our Census mapping connects it to 292 cities and communities in Puerto Rico. Some span more than one payment area; confirm with the service ZIP.

• Aceitunas
• Adjuntas
• Aguada
• Aguadilla
• Aguas Buenas
• Aguas Claras
• Aguilita
• Aibonito

Browse all communities in Puerto Rico

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