No office rate
Choose 27420 for reconstruction to address a dislocating patella. Choose 27424 when the operation removes or revises the patella itself.
On this page
CMS RVU26D · Effective 2026-10-01
27424 Patella surgery Medicare reimbursement rates
Report 27424 when an orthopedic surgeon surgically removes or revises the kneecap, rather than reconstructing it for instability or resurfacing it with an implant. Compare 27424 office and facility rates across CMS payment localities.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 27424?
The service location and office or facility setting determine which base rate applies. These are the supported base rates for the 109 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Where 27424 pays more and less
Orthopedic surgery
About 27424: Patella removal or revision
Report 27424 when an orthopedic surgeon surgically removes or revises the kneecap, rather than reconstructing it for instability or resurfacing it with an implant.
This code represents an operation to remove or revise the patella. Orthopedic surgeons typically perform it in a hospital or ambulatory surgical setting when the kneecap itself requires operative treatment, such as after significant damage or a prior patellar procedure. The operative report should make clear what was done to the patella and why; a procedure aimed at correcting patellar instability or resurfacing the patella is a different service.
Report 27424 for the patellar removal or revision actually performed, supported by the preoperative findings and operative details. CMS assigns a 90-day global period: the day-before preoperative visit and related postoperative care during the following 90 days are included. When multiple procedures occur 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, modifier 50 is paid at 150%. An assistant at surgery may be paid; co-surgeons require supporting documentation, and team surgery is not permitted.
CMS billing rules for 27424
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral procedure with modifier 50 is paid at 150%.
- Assistant at surgery
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU9.98 · 47%
- Practice expense (office) RVU8.97 · 43%
- Malpractice RVU2.13 · 10%
34
Medicare services in 2024 · #5577 by national volume
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.
27424 compared with similar codes
Office rate ranges across all CMS payment localities, from the same CMS release.
No office rate
Code 27422 describes instability reconstruction that includes extensor realignment or muscle advancement; 27424 describes removal or revision of the kneecap.
No office rate
Code 27437 is patellar arthroplasty without a prosthesis. It is not the code for removal or revision of the patella.
No office rate
Code 27438 covers patellar arthroplasty with a prosthetic implant; 27424 covers removal or revision rather than implant-based resurfacing.
See how rates vary across the country
27424 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.
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 all state and territory rates as a table
| State / territory | 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 |
Compare 27424 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | Office Unavailable | Facility $635.76 |
| Alaska* | Office Unavailable | Facility $858.29 |
| Arizona | Office Unavailable | Facility $684.56 |
| Arkansas | Office Unavailable | Facility $627.34 |
| Atlanta | Office Unavailable | Facility $724.18 |
| Austin | Office Unavailable | Facility $714.02 |
| Bakersfield | Office Unavailable | Facility $711.37 |
| Baltimore/Surr. Cntys | Office Unavailable | Facility $748.16 |
| Beaumont | Office Unavailable | Facility $672.08 |
| Brazoria | Office Unavailable | Facility $688.41 |
| Chicago | Office Unavailable | Facility $800.05 |
| Chico | Office Unavailable | Facility $705.51 |
| Colorado | Office Unavailable | Facility $711.69 |
| Connecticut | Office Unavailable | Facility $748.77 |
| Dallas | Office Unavailable | Facility $695.79 |
| Dc + Md/Va Suburbs | Office Unavailable | Facility $783.46 |
| Delaware | Office Unavailable | Facility $694.98 |
| Detroit | Office Unavailable | Facility $742.41 |
| East St. Louis | Office Unavailable | Facility $752.26 |
| El Centro | Office Unavailable | Facility $705.86 |
| Fort Lauderdale | Office Unavailable | Facility $765.47 |
| Fort Worth | Office Unavailable | Facility $693.72 |
| Fresno | Office Unavailable | Facility $705.51 |
| Galveston | Office Unavailable | Facility $692.42 |
| Hanford-Corcoran | Office Unavailable | Facility $705.51 |
| Hawaii, Guam | Office Unavailable | Facility $715.19 |
| Houston | Office Unavailable | Facility $731.41 |
| Idaho | Office Unavailable | Facility $642.63 |
| Indiana | Office Unavailable | Facility $645.65 |
| Iowa | Office Unavailable | Facility $635.72 |
| Kansas | Office Unavailable | Facility $640.04 |
| Kentucky | Office Unavailable | Facility $664.79 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Office Unavailable | Facility $748.68 |
| Madera | Office Unavailable | Facility $705.51 |
| Manhattan | Office Unavailable | Facility $815.65 |
| Merced | Office Unavailable | Facility $705.51 |
| Metropolitan Boston | Office Unavailable | Facility $768.06 |
| Metropolitan Kansas City | Office Unavailable | Facility $684.18 |
| Metropolitan Philadelphia | Office Unavailable | Facility $736.11 |
| Metropolitan St. Louis | Office Unavailable | Facility $689.85 |
| Miami | Office Unavailable | Facility $825.15 |
| Minnesota | Office Unavailable | Facility $662.69 |
| Mississippi | Office Unavailable | Facility $643.88 |
| Modesto | Office Unavailable | Facility $705.51 |
| Montana** | Office Unavailable | Facility $703.95 |
| Napa | Office Unavailable | Facility $785.36 |
| Nebraska | Office Unavailable | Facility $636.77 |
| Nevada** | Office Unavailable | Facility $692.51 |
| New Hampshire | Office Unavailable | Facility $707.48 |
| New Mexico | Office Unavailable | Facility $693.52 |
| New Orleans | Office Unavailable | Facility $696.09 |
| North Carolina | Office Unavailable | Facility $658.33 |
| North Dakota** | Office Unavailable | Facility $661.83 |
| Northern Nj | Office Unavailable | Facility $777.87 |
| Nyc Suburbs/Long Island | Office Unavailable | Facility $843.02 |
| Ohio | Office Unavailable | Facility $678.59 |
| Oklahoma | Office Unavailable | Facility $656.17 |
| Oxnard-Thousand Oaks-Ventura | Office Unavailable | Facility $741.13 |
| Portland | Office Unavailable | Facility $724.47 |
| Poughkpsie/N Nyc Suburbs | Office Unavailable | Facility $762.49 |
| Puerto Rico | Office Unavailable | Facility $706.32 |
| Queens | Office Unavailable | Facility $811.40 |
| Redding | Office Unavailable | Facility $705.51 |
| Rest Of California | Office Unavailable | Facility $705.51 |
| Rest Of Florida | Office Unavailable | Facility $726.69 |
| Rest Of Georgia | Office Unavailable | Facility $685.39 |
| Rest Of Illinois | Office Unavailable | Facility $718.08 |
| Rest Of Louisiana | Office Unavailable | Facility $666.65 |
| Rest Of Maine | Office Unavailable | Facility $653.23 |
| Rest Of Maryland | Office Unavailable | Facility $705.19 |
| Rest Of Massachusetts | Office Unavailable | Facility $710.86 |
| Rest Of Michigan | Office Unavailable | Facility $687.20 |
| Rest Of Missouri | Office Unavailable | Facility $660.90 |
| Rest Of New Jersey | Office Unavailable | Facility $751.89 |
| Rest Of New York | Office Unavailable | Facility $667.98 |
| Rest Of Oregon | Office Unavailable | Facility $681.76 |
| Rest Of Pennsylvania | Office Unavailable | Facility $675.61 |
| Rest Of Texas | Office Unavailable | Facility $681.91 |
| Rest Of Washington | Office Unavailable | Facility $707.30 |
| Rhode Island | Office Unavailable | Facility $712.63 |
| Riverside-San Bernardino-Ontario | Office Unavailable | Facility $728.40 |
| Sacramento-Roseville-Folsom | Office Unavailable | Facility $731.92 |
| Salinas | Office Unavailable | Facility $729.05 |
| San Diego-Chula Vista-Carlsbad | Office Unavailable | Facility $740.23 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Office Unavailable | Facility $820.11 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Office Unavailable | Facility $817.69 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Office Unavailable | Facility $840.17 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Office Unavailable | Facility $830.28 |
| San Luis Obispo-Paso Robles | Office Unavailable | Facility $718.39 |
| Santa Cruz-Watsonville | Office Unavailable | Facility $742.50 |
| Santa Maria-Santa Barbara | Office Unavailable | Facility $730.15 |
| Santa Rosa-Petaluma | Office Unavailable | Facility $749.39 |
| Seattle (King Cnty) | Office Unavailable | Facility $775.75 |
| South Carolina | Office Unavailable | Facility $670.65 |
| South Dakota** | Office Unavailable | Facility $656.85 |
| Southern Maine | Office Unavailable | Facility $675.14 |
| Stockton | Office Unavailable | Facility $705.51 |
| Suburban Chicago | Office Unavailable | Facility $769.44 |
| Tennessee | Office Unavailable | Facility $643.89 |
| Utah | Office Unavailable | Facility $678.86 |
| Vallejo | Office Unavailable | Facility $781.88 |
| Vermont | Office Unavailable | Facility $665.95 |
| Virgin Islands | Office Unavailable | Facility $706.32 |
| Virginia | Office Unavailable | Facility $678.08 |
| Visalia | Office Unavailable | Facility $705.51 |
| West Virginia | Office Unavailable | Facility $695.51 |
| Wisconsin | Office Unavailable | Facility $642.28 |
| Wyoming** | Office Unavailable | Facility $685.59 |
| Yuba City | Office Unavailable | Facility $705.51 |
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27424 billing questions
How is 27424 different from patellar instability reconstruction?
Use 27424 when the operation removes or revises the patella itself. Codes 27420 and 27422 describe reconstruction directed at a dislocating patella.
Is this the code for patellar resurfacing with an implant?
No. Code 27438 describes patellar arthroplasty with a prosthetic implant; 27424 is for removal or revision of the patella.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and related postoperative care during the 90 days after surgery.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeons are paid only when supporting documentation is provided; team surgery is not permitted.
How is bilateral surgery handled?
CMS pays bilateral surgery reported with modifier 50 at 150%.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
2,88227418,,Repair degenerated kneecap,A,,11.31,9.28,NA,9.28,,2.26,22.85,22.85,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,88327420,,Revision of unstable kneecap,A,,10.00,8.98,NA,8.98,,2.13,21.11,21.11,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,88427422,,Revision of unstable kneecap,A,,9.95,8.89,NA,8.89,,2.08,20.92,20.92,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,88527424,,Revision/removal of kneecap,A,,9.98,8.97,NA,8.97,,2.13,21.08,21.08,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,88627425,,Lat retinacular release open,A,,5.26,6.89,NA,6.89,,1.11,13.26,13.26,0,090,0.10,0.69,0.21,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,88727427,,Reconstruction knee,A,,9.55,8.42,NA,8.42,,1.87,19.84,19.84,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,88827428,,Reconstruction knee,A,,15.19,12.73,NA,12.73,,3.23,31.15,31.15,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00