CPT code 27486: Knee revision, one prosthetic component2026 Medicare rate & RVUs in Maryland
Reports revision of an existing total knee replacement when the surgeon revises one prosthetic component, such as for loosening, wear, or instability.
CMS doesn’t publish an office rate for 27486 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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What 27486 covers
An orthopedic surgeon uses this code when revising one component of an existing total knee replacement, such as a femoral or tibial component. Typical reasons include component loosening, wear, or instability. The operation may include removing the old component and placing its replacement; the code also covers use of allograft. These revisions are generally performed in an operating room, usually in a hospital or ambulatory surgery setting.
Select this code when the operative report supports revision of one component, rather than revision of both components. Document the existing prosthesis, the component revised, the reason for revision, and the work performed. 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%. 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.
Where 27486 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 | $1,352.61 |
| Rest of Maryland | Unavailable | $1,275.18 |
| Washington, DC area | Unavailable | $1,407.12 |
How the 27486 rate is calculated
Each of 27486’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 · 27486
RVUs × geographic indexes × conversion factor
Work20.59
20.59 RVUs× 1.000 GPCI
Practice expense13.23
13.23 RVUs× 1.000 GPCI
Malpractice4.35
4.35 RVUs× 1.000 GPCI
Adjusted RVUs
38.1700
Conversion factor
$33.4009
Medicare rate
$1,274.91
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 27486
27486 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 27486
Knee revision, one prosthetic component
| 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 · 27486
Knee revision, one prosthetic component
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
27486 without 50 · national facility
$1,274.91
Knee revision, one prosthetic component
27486-50 · Bilateral: 150%
$1,912.37
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).
27486 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 27487Knee revisionBoth femoral and tibial components
- This code is for revision of one prosthetic component; 27487 is for revision of both components.
- 27447Total knee replacementMedial and lateral compartments
- Use 27447 for primary total knee replacement. This code is for revising one component of an existing total knee prosthesis.
- 27488Knee prosthesis removalSpacer may be inserted
- Use 27488 when the knee prosthesis is removed without replacement. This code describes revision and replacement of one component.
- 27446Partial knee replacementOne compartment
- Code 27446 describes primary partial knee arthroplasty. This code applies to revision of one component in an existing total knee prosthesis.
27486 billing questions
How do I distinguish this code from 27487?
Use this code when one prosthetic component is revised. Code 27487 describes revision of both components.
Can removal of the old component be billed separately?
Removal performed as part of replacing the component is part of the revision service. Code 27488 is for removal of a knee prosthesis without replacement.
Does allograft use change the code selection?
No. This code covers revision of one component with or without allograft; the component count remains the key distinction.
What documentation supports reporting this code?
The operative report should identify the existing knee prosthesis, the single component revised, the reason for revision, and the work performed.
How is bilateral reporting handled?
For a bilateral procedure reported with modifier 50, CMS pays 150%.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
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
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