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Billing code 27425: Patellar releaseMedicare rate & RVUs

Open lateral retinacular release divides tight tissue along the outer patella to address excessive lateral restraint or patellar maltracking.

CMS RVU26DEffective Oct 1, 2026109 payment localities863 Medicare services in 2024

Medicare pays $442.90 for 27425 nationally in a facility.

Medicare rate · 27425

Patellar release

Swap in your local Medicare rate.

Work RVUs
5.26
Total RVUs
13.26
Global days
090

National rate · 2026

$442.90

Facility setting, before claim adjustments.

See every locality for 27425 → · 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 27425 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 27425 covers

The surgeon exposes and releases tight tissue along the outside of the kneecap through an open approach, reducing excessive lateral pull or restraint. Orthopedic surgeons commonly perform the procedure for patellar tilt or maltracking associated with a tight lateral retinaculum, often in a hospital operating room. The operative report should establish the indication and describe the open exposure and release performed.

Report 27425 when the documented service is an open lateral retinacular release; an arthroscopic release is represented by a different code. Medicare assigns a 90-day global period, including the day-before preoperative visit and related postoperative care. When other procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple procedure reduction. For bilateral release reported with modifier 50, Medicare pays 150%. Medicare does not pay an assistant at surgery; 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 27425 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

27425 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$398.04
Alaska*Unavailable$529.05
ArizonaUnavailable$430.42
ArkansasUnavailable$392.47
AtlantaUnavailable$454.56
AustinUnavailable$452.37
BakersfieldUnavailable$453.83
Baltimore/Surr. CntysUnavailable$471.29
BeaumontUnavailable$419.55
BrazoriaUnavailable$434.07

27425 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
27425 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 27425 rate is calculated

Each of 27425’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 · 27425

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 5.26Practice expense 6.89Malpractice 1.11

13.2600 adjusted RVUs×$33.4009 conversion factor=$442.90

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

Payment rules and modifiers for 27425

27425 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 27425

Patellar release

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)1Not paid (statutory restriction).
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 · 27425

Patellar release

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

27425 without 50 · national facility

$442.90

Patellar release

27425-50 · Bilateral: 150%

$664.35

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

27425 compared with similar codes

Compare codes

27425 vs 29873 vs 27420 vs 27422 vs 27418: national Medicare rates

Swap in your local Medicare rate.

  • 27425
    Patellar release · 5.26 wRVU
    —
  • 29873
    Knee arthroscopy · 6.08 wRVU
    —
  • 27420
    Patellar reconstruction · 10 wRVU
    —
  • 27422
    Patellar reconstruction · 9.95 wRVU
    —
  • 27418
    Tubercleplasty · 11.31 wRVU
    —

How to choose

29873Knee arthroscopy
Both describe lateral retinacular release, but 27425 is open and 29873 is arthroscopic. Select according to the approach documented.
27420Patellar reconstruction
27425 releases lateral soft tissue. 27420 describes reconstruction for a dislocating patella, a different operation for patellar instability.
27422Patellar reconstruction
27425 is an isolated open lateral release; 27422 involves patellar reconstruction with extensor mechanism realignment.
27418Tubercleplasty
27425 releases the lateral retinaculum. 27418 is a tibial tubercleplasty, a bony procedure used to address patellar alignment.

Codes related to 27425

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

Codes related to 27425
CodeHow it relatesNational office range
Used instead
29873Knee arthroscopyArthroscopic approach for lateral retinacular release rather than the open approach.No office rate
27418TubercleplastyTibial tubercleplasty addresses patellar alignment through a bony procedure.No office rate
27420Patellar reconstructionPatellar reconstruction may be selected for dislocation requiring more than isolated lateral release.No office rate
27422Patellar reconstructionPatellar reconstruction with extensor mechanism realignment treats instability beyond isolated lateral tightness.No office rate

27425 billing questions

How does 27425 differ from the arthroscopic lateral release code?

27425 is for an open approach. For an arthroscopic lateral retinacular release, consider 29873.

What documentation supports reporting 27425?

Document the patellar problem prompting surgery and the open exposure and lateral retinacular release actually performed. The operative note should distinguish the release from any separately described patellar or bony procedure.

Can modifier 50 be used for release on both knees?

CMS identifies 27425 as a bilateral procedure. When both sides are treated and modifier 50 is reported, Medicare pays 150%.

What happens when another procedure is performed in the same session?

Under the standard multiple procedure rule, Medicare pays the highest-valued procedure in full and pays other procedures at 50%.

Is an assistant or co-surgeon payable for 27425?

Medicare does not pay an assistant at surgery for this code. 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 27425PPRRVU2026_Oct_nonQPP.csv, line 2,886 (RVU26D)

Open CMS sourceHow we calculate rates

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