CPT code 27570: Knee manipulation, under anesthesia2026 Medicare rate & RVUs in Puerto Rico
Reports controlled manipulation of a stiff knee under anesthesia, commonly to improve restricted motion after surgery when no surgical release is performed.
In Puerto Rico, Medicare pays $150.66 for 27570 in a facility. There’s no office rate.
Check a contract rate as a % of Medicare · 27570 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 27570 covers
An orthopedic surgeon manipulates the knee while the patient is under anesthesia to address substantial stiffness or restricted range of motion. A common setting is a hospital or ambulatory surgery center, including treatment of persistent stiffness after knee replacement. The service is a closed manipulation; it does not describe arthroscopic release of adhesions or an open lengthening procedure.
Report the service when the operative note supports manipulation under anesthesia and identifies the treated knee and the motion limitation addressed. Related postoperative visits are included in the 10-day global period. 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% multiple-procedure reduction. For bilateral manipulation, modifier 50 is paid at 150%. Medicare does not pay an assistant at surgery for this code; co-surgeons and team surgery are 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 27570
Across 109 of 109 payment localities, the facility rate for 27570 runs from $132.81 in Arkansas to $185.65 in San Benito County, CA. Puerto Rico pays $150.66. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Puerto Rico · this page$150.66
- Los Angeles, CA · California$162.70+$12.04
- Washington, DC area · District of Columbia$168.61+$17.95
- Miami, FL · Florida$172.11+$21.45
- Chicago, IL · Illinois$166.78+$16.12
- Manhattan, NY · New York$173.78+$23.12
- Alaska · Alaska$178.79+$28.13
Other areas in Puerto Rico first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | — | $134.71 |
| ArkansasArkansas | — | $132.81 |
| ArizonaArizona | — | $145.74 |
| Bakersfield, CACalifornia | — | $153.85 |
| Chico, CACalifornia | — | $152.83 |
| El Centro, CACalifornia | — | $152.89 |
| Fresno, CACalifornia | — | $152.83 |
| Hanford, CACalifornia | — | $152.83 |
| Madera, CACalifornia | — | $152.83 |
| Merced, CACalifornia | — | $152.83 |
| Modesto, CACalifornia | — | $152.83 |
| Napa, CACalifornia | — | $172.75 |
| Oxnard, CACalifornia | — | $161.35 |
| Redding, CACalifornia | — | $152.83 |
| Rest of CaliforniaCalifornia | — | $152.83 |
| Riverside, CACalifornia | — | $156.80 |
| Sacramento, CACalifornia | — | $159.24 |
| Salinas, CACalifornia | — | $158.63 |
| San Diego, CACalifornia | — | $161.58 |
| Marin County, CACalifornia | — | $181.29 |
| San Francisco, CACalifornia | — | $180.87 |
| San Benito County, CACalifornia | — | $185.65 |
| Santa Clara County, CACalifornia | — | $183.94 |
| San Luis Obispo, CACalifornia | — | $156.23 |
| Santa Cruz, CACalifornia | — | $162.48 |
| Santa Maria, CACalifornia | — | $159.01 |
| Santa Rosa, CACalifornia | — | $164.04 |
| Stockton, CACalifornia | — | $152.83 |
| Vallejo, CACalifornia | — | $172.14 |
| Visalia, CACalifornia | — | $152.83 |
| Yuba City, CACalifornia | — | $152.83 |
| ColoradoColorado | — | $153.03 |
| ConnecticutConnecticut | — | $159.83 |
| DelawareDelaware | — | $148.06 |
| Fort Lauderdale, FLFlorida | — | $160.98 |
| Rest of FloridaFlorida | — | $152.70 |
| Atlanta, GAGeorgia | — | $153.90 |
| Rest of GeorgiaGeorgia | — | $143.79 |
| Hawaii, Guam, HIHawaii | — | $155.61 |
| IowaIowa | — | $135.79 |
| IdahoIdaho | — | $137.12 |
| East St. Louis, ILIllinois | — | $156.17 |
| Rest of IllinoisIllinois | — | $150.04 |
| Suburban Chicago, ILIllinois | — | $162.06 |
| IndianaIndiana | — | $137.84 |
| KansasKansas | — | $136.24 |
| KentuckyKentucky | — | $140.13 |
| New Orleans, LALouisiana | — | $146.98 |
| Rest of LouisianaLouisiana | — | $140.35 |
| Metropolitan Boston, MAMassachusetts | — | $166.36 |
| Rest of MassachusettsMassachusetts | — | $152.59 |
| Baltimore area, MDMaryland | — | $159.61 |
| Rest of MarylandMaryland | — | $150.49 |
| Rest of MaineMaine | — | $138.97 |
| Southern Maine, MEMaine | — | $144.70 |
| Detroit, MIMichigan | — | $155.68 |
| Rest of MichiganMichigan | — | $144.68 |
| MinnesotaMinnesota | — | $143.57 |
| Metropolitan Kansas City, MOMissouri | — | $144.86 |
| Metropolitan St. Louis, MOMissouri | — | $146.20 |
| Rest of MissouriMissouri | — | $138.72 |
| MississippiMississippi | — | $135.74 |
| MontanaMontana | — | $149.95 |
| North CarolinaNorth Carolina | — | $140.20 |
| North DakotaNorth Dakota | — | $142.63 |
| NebraskaNebraska | — | $136.19 |
| New HampshireNew Hampshire | — | $151.67 |
| Northern New JerseyNew Jersey | — | $167.16 |
| Rest of New JerseyNew Jersey | — | $160.79 |
| New MexicoNew Mexico | — | $145.88 |
| NevadaNevada | — | $147.99 |
| NYC suburbs and Long Island, NYNew York | — | $179.26 |
| Poughkeepsie and northern NYC suburbs, NYNew York | — | $162.72 |
| Queens, NYNew York | — | $173.58 |
| Rest of New YorkNew York | — | $142.34 |
| OhioOhio | — | $143.18 |
| OklahomaOklahoma | — | $138.74 |
| Portland, OROregon | — | $156.53 |
| Rest of OregonOregon | — | $145.98 |
| Metropolitan Philadelphia, PAPennsylvania | — | $156.65 |
| Rest of PennsylvaniaPennsylvania | — | $142.80 |
| Rhode IslandRhode Island | — | $152.36 |
| South CarolinaSouth Carolina | — | $142.10 |
| South DakotaSouth Dakota | — | $141.76 |
| TennesseeTennessee | — | $137.04 |
| Austin, TXTexas | — | $153.27 |
| Beaumont, TXTexas | — | $141.97 |
| Brazoria, TXTexas | — | $147.01 |
| Dallas, TXTexas | — | $148.42 |
| Fort Worth, TXTexas | — | $147.79 |
| Galveston, TXTexas | — | $147.76 |
| Houston, TXTexas | — | $154.53 |
| Rest of TexasTexas | — | $144.73 |
| UtahUtah | — | $143.96 |
| VirginiaVirginia | — | $144.99 |
| Virgin Islands, VIUnited States Virgin Islands | — | $150.66 |
| VermontVermont | — | $143.07 |
| Rest of WashingtonWashington | — | $151.97 |
| King County, WAWashington | — | $168.60 |
| WisconsinWisconsin | — | $138.09 |
| West VirginiaWest Virginia | — | $144.93 |
| WyomingWyoming | — | $146.76 |
27570 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 27570 rate is calculated
Each of 27570’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 · 27570
RVUs × geographic indexes × conversion factor
Work1.75
1.75 RVUs× 1.000 GPCI
Practice expense2.37
2.37 RVUs× 1.000 GPCI
Malpractice0.37
0.37 RVUs× 1.000 GPCI
Adjusted RVUs
4.4900
Conversion factor
$33.4009
Medicare rate
$149.97
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Puerto Rico inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
2,953
- Code
- 27570
- Physician work
- 1.75
- Practice expense
- 2.37
- Malpractice
- 0.37
GPCI2026.csv
91
- Locality
- Puerto Rico
- Physician work
- 1.000
- Practice expense
- 1.011
- Malpractice
- 0.985
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.75 | × 1.000 | 1.7500 |
| Practice expense | 2.37 | × 1.011 | 2.3961 |
| Malpractice | 0.37 | × 0.985 | 0.3644 |
| Total RVUs | 4.5105 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Puerto Rico$150.66
Facility: (1.75 × 1 + 2.37 × 1.011 + 0.37 × 0.985) × $33.4009 = $150.66
Payment rules and modifiers for 27570
27570 has a 10-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 27570
Knee manipulation, under anesthesia
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 010 | Minor procedure: the day of the procedure plus 10 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) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.80/0.10 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 27570
Knee manipulation, under anesthesia
10-day global period ends
Oct 11, 2026
Covers Oct 1, 2026 through Oct 11, 2026 (11 days).
Visit on Oct 31, 2026
After the global period ends: visits and procedures are billed normally.
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
27570 without 50 · national facility
$149.97
Knee manipulation, under anesthesia
27570-50 · Bilateral: 150%
$224.96
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 27570 has changed in Puerto Rico
27570 · 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 | $150.66 | RVU26D |
| 2026-07-01 | Not available in this setting | $150.66 | RVU26C |
| 2026-04-01 | Not available in this setting | $150.66 | RVU26B |
| 2026-01-01 | Not available in this setting | $150.66 | RVU26A |
| 2025-10-01 | Not available in this setting | $154.66 | RVU25D |
| 2025-07-01 | Not available in this setting | $154.66 | RVU25C |
| 2025-04-01 | Not available in this setting | $154.66 | RVU25B |
| 2025-01-01 | Not available in this setting | $154.66 | RVU25A |
| 2024-10-01 | Not available in this setting | $156.82 | RVU24D |
| 2024-07-01 | Not available in this setting | $156.82 | RVU24C |
| 2024-04-01 | Not available in this setting | $156.82 | RVU24B |
| 2024-03-09 | Not available in this setting | $156.82 | RVU24AR |
| 2024-01-01 | Not available in this setting | $154.26 | RVU24A |
| 2023-10-01 | Not available in this setting | $157.37 | RVU23D |
| 2023-07-01 | Not available in this setting | $156.90 | RVU23C |
| 2023-04-01 | Not available in this setting | $156.90 | RVU23B |
| 2023-01-01 | Not available in this setting | $156.90 | RVU23A |
| 2022-10-01 | Not available in this setting | $157.59 | RVU22D |
| 2022-07-01 | Not available in this setting | $157.59 | RVU22C |
| 2022-04-01 | Not available in this setting | $157.59 | RVU22B |
| 2022-01-01 | Not available in this setting | $157.59 | RVU22A |
| 2021-10-01 | Not available in this setting | $156.11 | RVU21D |
| 2021-07-01 | Not available in this setting | $156.11 | RVU21C |
| 2021-04-01 | Not available in this setting | $156.11 | RVU21B |
| 2021-01-01 | Not available in this setting | $156.11 | RVU21A |
| 2020-10-01 | Not available in this setting | $157.11 | RVU20D |
| 2020-07-01 | Not available in this setting | $157.11 | RVU20C |
| 2020-04-01 | Not available in this setting | $157.11 | RVU20B |
| 2020-01-01 | Not available in this setting | $157.11 | RVU20A |
| 2019-10-01 | Not available in this setting | $156.83 | RVU19D |
| 2019-07-01 | Not available in this setting | $156.83 | RVU19C |
| 2019-04-01 | Not available in this setting | $156.83 | RVU19B |
| 2019-01-01 | Not available in this setting | $156.83 | RVU19A |
| 2018-10-01 | Not available in this setting | $156.30 | RVU18D |
| 2018-07-01 | Not available in this setting | $156.30 | RVU18C |
| 2018-04-01 | Not available in this setting | $156.30 | RVU18B |
| 2018-01-01 | Not available in this setting | $156.30 | RVU18AR1 |
| 2017-10-01 | Not available in this setting | $139.43 | RVU17D |
| 2017-07-01 | Not available in this setting | $139.43 | RVU17C |
| 2017-04-01 | Not available in this setting | $139.43 | RVU17B |
| 2017-01-01 | Not available in this setting | $139.43 | RVU17A |
| 2016-10-01 | Not available in this setting | $123.00 | RVU16D |
| 2016-07-01 | Not available in this setting | $123.00 | RVU16C |
| 2016-04-01 | Not available in this setting | $123.00 | RVU16B |
| 2016-01-01 | Not available in this setting | $123.00 | RVU16A |
| 2015-10-01 | Not available in this setting | $123.70 | RVU15D |
| 2015-07-01 | Not available in this setting | $123.70 | RVU15C |
| 2015-04-01 | Not available in this setting | $123.08 | RVU15B |
| 2015-01-01 | Not available in this setting | $123.08 | RVU15A |
| 2014-10-01 | Not available in this setting | $120.87 | RVU14D |
| 2014-07-01 | Not available in this setting | $120.87 | RVU14C |
| 2014-04-01 | Not available in this setting | $120.87 | RVU14B |
| 2014-01-01 | Not available in this setting | $120.87 | RVU14A |
| 2013-10-01 | Not available in this setting | $118.45 | RVU13D |
| 2013-07-01 | Not available in this setting | $118.45 | RVU13C |
| 2013-04-01 | Not available in this setting | $118.45 | RVU13B |
| 2013-01-01 | Not available in this setting | $118.45 | RVU13AR |
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
27570 billing questions
When should this code be chosen instead of arthroscopic lysis of adhesions?
Use this code for manipulation under anesthesia without arthroscopic release. CPT 29884 describes arthroscopic treatment of knee adhesions, with or without manipulation.
What documentation supports reporting the service?
Document the knee stiffness or restricted motion, the knee treated, the manipulation performed under anesthesia, and the clinical result, such as motion before and after the procedure.
Are postoperative visits included?
Related postoperative visits during the 10-day global period are included in this procedure's payment.
How is manipulation of both knees reported?
Report bilateral treatment with modifier 50; CMS pays the bilateral procedure at 150%.
Can an assistant or co-surgeon be reported?
Medicare does not pay an assistant at surgery for this code. Co-surgeons and team surgery are not permitted.
What happens if another procedure is performed in the same session?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction, with payment 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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