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Billing code 27416: Knee cartilage graftMedicare rate & RVUs

Open transfer of a patient’s own osteochondral tissue treats a focal knee defect when healthy cartilage and underlying bone are grafted into the affected area.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare pays $902.49 for 27416 nationally in a facility.

Medicare rate · 27416

Knee cartilage graft

Swap in your local Medicare rate.

Work RVUs
13.81
Total RVUs
27.02
Global days
090

National rate · 2026

$902.49

Facility setting, before claim adjustments.

See every locality for 27416 → · 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 27416 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 27416 covers

The surgeon harvests one or more plugs of cartilage and underlying bone from a less weight-bearing area of the patient’s knee and transfers them to a focal defect in the same knee. Orthopedic surgeons use this approach for selected cartilage and osteochondral injuries, including defects associated with osteochondritis dissecans. The service is performed through an open approach, commonly in a hospital or ambulatory surgery setting.

Report the code when the operative record supports open autologous osteochondral grafting, including the defect’s location and the harvest and recipient sites. Distinguish it from grafting with donor tissue or from cartilage-cell implantation. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For same-session procedures, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment requires documented medical necessity; 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.

Where 27416 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

27416 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$817.00
Alaska*Unavailable$1,111.33
ArizonaUnavailable$877.72
ArkansasUnavailable$806.50
AtlantaUnavailable$929.10
AustinUnavailable$912.12
BakersfieldUnavailable$905.79
Baltimore/Surr. CntysUnavailable$958.19
BeaumontUnavailable$864.65
BrazoriaUnavailable$881.49

27416 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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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
27416 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 27416 rate is calculated

Each of 27416’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 · 27416

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 13.81Practice expense 10.27Malpractice 2.94

27.0200 adjusted RVUs×$33.4009 conversion factor=$902.49

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

Payment rules and modifiers for 27416

27416 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 27416

Knee cartilage graft

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)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
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 · 27416

Knee cartilage graft

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

27416 without 50 · national facility

$902.49

Knee cartilage graft

27416-50 · Bilateral: 150%

$1,353.74

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

27416 compared with similar codes

Compare codes

27416 vs 27415 vs 27412 vs 29866: national Medicare rates

Swap in your local Medicare rate.

  • 27416
    Knee cartilage graft · 13.81 wRVU
    —
  • 27415
    Knee allograft · 19.5 wRVU
    —
  • 27412
    Cartilage implantation · 24.12 wRVU
    —
  • 29866
    Cartilage restoration · 14.3 wRVU
    —

How to choose

27415Knee allograft
Both describe open osteochondral grafting of the knee. Choose 27416 for tissue harvested from the patient; 27415 uses donor tissue.
27412Cartilage implantation
27412 involves an autologous chondrocyte implant. This code describes transferring the patient’s own osteochondral plugs, including underlying bone.
29866Cartilage restoration
Both involve knee osteochondral autografting, but 29866 is the arthroscopic procedure; 27416 is the open procedure.

Codes related to 27416

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

Codes related to 27416
CodeHow it relatesNational office range
Used instead
27415Knee allograftOpen knee osteochondral grafting with donor tissue rather than the patient’s own tissue.No office rate
27412Cartilage implantationKnee cartilage repair using an autologous chondrocyte implant instead of transferred osteochondral plugs.No office rate
29866Cartilage restorationArthroscopic approach for knee osteochondral autografting.No office rate

27416 billing questions

How does this differ from 27415?

This code is for osteochondral tissue harvested from the same patient. Code 27415 is the open procedure using donor osteochondral tissue.

How does this differ from 27412?

This code transfers osteochondral plugs, including bone, from the patient’s own knee. Code 27412 describes knee treatment using an autologous chondrocyte implant rather than transferred osteochondral plugs.

When is 29866 more appropriate?

Code 29866 describes arthroscopic osteochondral autografting. Use 27416 for the open approach when the documented procedure meets its service description.

What operative details support reporting?

Document the focal defect and its knee location, the open grafting technique, and the autologous harvest and recipient sites. Include laterality.

How is bilateral treatment reported?

For bilateral procedures, modifier 50 is paid at 150% under the CMS facts provided. The 90-day global period applies to the surgery.

Can an assistant surgeon be reported?

Assistant-at-surgery payment is allowed only when medical necessity is documented. Co-surgeons and team surgery are 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 27416PPRRVU2026_Oct_nonQPP.csv, line 2,881 (RVU26D)

Open CMS sourceHow we calculate rates

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