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Billing code 27422: Patellar reconstructionMedicare rate & RVUs

Reports operative reconstruction for a dislocating kneecap when treatment includes extensor-mechanism realignment, muscle advancement, or imbrication.

CMS RVU26DEffective Oct 1, 2026109 payment localities742 Medicare services in 2024

Medicare pays $698.75 for 27422 nationally in a facility.

Medicare rate · 27422

Patellar reconstruction

Swap in your local Medicare rate.

Work RVUs
9.95
Total RVUs
20.92
Global days
090

National rate · 2026

$698.75

Facility setting, before claim adjustments.

See every locality for 27422 → · 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 27422 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 27422 covers

An orthopedic surgeon uses this service to surgically address recurrent patellar instability, such as a kneecap that repeatedly slips out of position. The reconstruction includes realignment of the extensor mechanism, muscle advancement, or imbrication as part of stabilizing the patella. It is typically performed in a hospital or ambulatory surgery setting; CMS recorded these services in facility settings in 2024.

Choose this code when the operative report supports the instability reconstruction and the added realignment or muscle work, rather than a soft-tissue reconstruction without those elements. Document the affected knee, the instability being treated, and the structures and techniques used. Medicare assigns 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%. Bilateral reporting with modifier 50 is paid at 150%. An assistant at surgery 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 27422 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

27422 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$631.48
Alaska*Unavailable$853.02
ArizonaUnavailable$679.54
ArkansasUnavailable$623.18
AtlantaUnavailable$718.46
AustinUnavailable$708.71
BakersfieldUnavailable$706.40
Baltimore/Surr. CntysUnavailable$742.21
BeaumontUnavailable$667.09
BrazoriaUnavailable$683.45

27422 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
27422 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 27422 rate is calculated

Each of 27422’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 · 27422

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 9.95Practice expense 8.89Malpractice 2.08

20.9200 adjusted RVUs×$33.4009 conversion factor=$698.75

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

Payment rules and modifiers for 27422

27422 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 27422

Patellar reconstruction

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 · 27422

Patellar reconstruction

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

27422 without 50 · national facility

$698.75

Patellar reconstruction

27422-50 · Bilateral: 150%

$1,048.13

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

27422 compared with similar codes

Compare codes

27422 vs 27420 vs 27418 vs 27425: national Medicare rates

Swap in your local Medicare rate.

  • 27422
    Patellar reconstruction · 9.95 wRVU
    —
  • 27420
    Patellar reconstruction · 10 wRVU
    —
  • 27418
    Tubercleplasty · 11.31 wRVU
    —
  • 27425
    Patellar release · 5.26 wRVU
    —

How to choose

27420Patellar reconstruction
Both address a dislocating patella. Choose 27422 when the operative reconstruction includes extensor realignment, muscle advancement, or imbrication; 27420 represents the related reconstruction without those elements.
27418Tubercleplasty
This code concerns anterior tibial tubercle reconstruction. Code 27422 is for patellar-instability reconstruction with extensor realignment or muscle work.
27425Patellar release
Code 27425 represents open lateral retinacular release. It is not the broader patellar-instability reconstruction with extensor realignment reported under 27422.

Codes related to 27422

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

Codes related to 27422
CodeHow it relatesNational office range
Same family
27420Patellar reconstructionRelated patellar-instability reconstruction without the extensor realignment or muscle work distinguishing this code.No office rate
Used instead
27418TubercleplastyAddresses anterior tibial tubercle reconstruction rather than this code's patellar-instability reconstruction.No office rate
27425Patellar releaseDescribes open lateral retinacular release, a more limited procedure than patellar reconstruction with extensor realignment.No office rate

27422 billing questions

How does this differ from 27420?

Use 27422 when the reconstruction includes extensor-mechanism realignment, muscle advancement, or imbrication. Code 27420 is the related reconstruction without those added elements.

What should the operative report support?

Document patellar instability, the side treated, and the reconstruction performed, including any extensor realignment, muscle advancement, or imbrication.

How is bilateral surgery reported?

Report bilateral treatment with modifier 50. CMS lists bilateral payment at 150%.

What postoperative care is included?

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

Can an assistant or co-surgeon be paid?

Assistant-at-surgery payment may be made. Co-surgeons are paid only with 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 27422PPRRVU2026_Oct_nonQPP.csv, line 2,884 (RVU26D)

Open CMS sourceHow we calculate rates

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