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Billing code 27409: Knee ligament repairMedicare rate & RVUs

Report this code for primary surgical repair of both collateral and cruciate ligament injuries in the same knee, rather than reconstruction.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare pays $896.15 for 27409 nationally in a facility.

Medicare rate · 27409

Knee ligament repair

Swap in your local Medicare rate.

Work RVUs
13.37
Total RVUs
26.83
Global days
090

National rate · 2026

$896.15

Facility setting, before claim adjustments.

See every locality for 27409 → · Billed by an NP, PA or therapist? →

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 10 sections
  1. Medicare rate
  2. What 27409 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 27409 covers

This code describes primary repair of torn collateral and cruciate ligaments in one knee during the same operation. An orthopedic surgeon typically performs the procedure for a multiligament knee injury when the injured structures can be repaired primarily, such as by repairing or reattaching torn ligament tissue. The service is generally performed in a hospital operating room or ambulatory surgery center.

Report the code when the operative documentation supports primary repair of both ligament groups; it does not describe reconstruction in place of primary repair. The 90-day global period includes the day-before preoperative visit and related postoperative care for 90 days. 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. For bilateral surgery reported with modifier 50, CMS pays 150%. Assistant-at-surgery services may be paid; 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 27409 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

27409 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$810.53
Alaska*Unavailable$1,099.72
ArizonaUnavailable$871.45
ArkansasUnavailable$800.01
AtlantaUnavailable$922.29
AustinUnavailable$906.74
BakersfieldUnavailable$901.43
Baltimore/Surr. CntysUnavailable$951.72
BeaumontUnavailable$857.49
BrazoriaUnavailable$875.59

27409 rates by state

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

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Local rates. Clear comparisons.

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View every state and territory as a table
27409 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 27409 rate is calculated

Each of 27409’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 · 27409

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 13.37Practice expense 10.61Malpractice 2.85

26.8300 adjusted RVUs×$33.4009 conversion factor=$896.15

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 27409

27409 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 27409

Knee ligament repair

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
Assistant at surgery (80/81/82/AS)2Paid.
Co-surgeons (62)1Permitted with supporting documentation.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.69/0.21Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 27409

Knee ligament repair

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.

  • 24 Unrelated E/M visit by the same physician
  • 79 Unrelated procedure (starts its own global period)
  • 58 Staged, more extensive, or therapy procedure that was planned
  • 78 Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 50 · payment effect

With and without the modifier

27409 without 50 · national facility

$896.15

Knee ligament repair

27409-50 · Bilateral: 150%

$1,344.23

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).

When to use modifier 50

27409 compared with similar codes

Compare codes

27409 vs 27405 vs 27407 vs 27429: national Medicare rates

Swap in your local Medicare rate.

  • 27409
    Knee ligament repair · 13.37 wRVU
    —
  • 27405
    Knee ligament repair · 8.85 wRVU
    —
  • 27407
    Cruciate ligament repair · 10.58 wRVU
    —
  • 27429
    Knee reconstruction · 17.1 wRVU
    —

How to choose

27405Knee ligament repair
Use 27405 for primary repair of the collateral ligament group alone. Use 27409 when the primary repair includes both collateral and cruciate ligament groups in the same knee.
27407Cruciate ligament repair
Use 27407 for primary repair of the cruciate ligament group alone. Use 27409 when the collateral ligament group is also primarily repaired.
27429Knee reconstruction
27429 describes combined intra-articular and extra-articular ligament reconstruction. This code describes primary repair of torn collateral and cruciate ligament groups.

Codes related to 27409

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

Codes related to 27409
CodeHow it relatesNational office range
Same family
27405Knee ligament repairPrimary repair of the collateral ligament group alone.No office rate
27407Cruciate ligament repairPrimary repair of the cruciate ligament group alone.No office rate
Used instead
27427Knee reconstructionExtra-articular knee ligament reconstruction rather than primary repair of both groups.No office rate
27428Knee reconstructionIntra-articular knee ligament reconstruction rather than primary repair of both groups.No office rate
27429Knee reconstructionCombined intra-articular and extra-articular knee ligament reconstruction.No office rate

27409 billing questions

When should I report this instead of 27405 or 27407?

Report this code when the surgeon primarily repairs both collateral and cruciate ligament injuries in the same knee. Codes 27405 and 27407 describe primary repair of the collateral or cruciate ligament group, respectively.

Can I report 27405 and 27407 with this code for the same repairs?

This code represents primary repair of both ligament groups in the same knee. Do not separately report the single-group repair codes for the same work.

How does this differ from knee ligament reconstruction?

This code is for primary repair of injured ligament tissue. When the surgeon performs ligament reconstruction instead, select the reconstruction code that matches the operative work.

What postoperative care is included?

The 90-day global period includes the day-before preoperative visit and related postoperative care for 90 days.

How are bilateral and multiple procedures handled?

Bilateral surgery reported with modifier 50 is paid at 150%. In a same-session multiple-procedure claim, the highest-valued procedure is paid in full and other procedures are subject to a 50% reduction.

May an assistant or co-surgeon be reported?

Assistant-at-surgery services may be paid. 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
RVUs for 27409PPRRVU2026_Oct_nonQPP.csv, line 2,878 (RVU26D)

Open CMS sourceHow we calculate rates

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