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Billing code 27438: Patellar arthroplastyMedicare rate & RVUs

Reports surgical replacement or resurfacing of the patella with a prosthetic implant when the procedure is limited to the kneecap rather than a total knee replacement.

CMS RVU26DEffective Oct 1, 2026109 payment localities1.5K Medicare services in 2024

Medicare pays $781.92 for 27438 nationally in a facility.

Medicare rate · 27438

Patellar arthroplasty

Swap in your local Medicare rate.

Work RVUs
11.59
Total RVUs
23.41
Global days
090

National rate · 2026

$781.92

Facility setting, before claim adjustments.

See every locality for 27438 → · 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 27438 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 27438 covers

An orthopedic surgeon replaces or resurfaces the joint-facing surface of the patella with a prosthetic implant. The procedure addresses patellar joint damage when the operative plan is for patellar arthroplasty, rather than replacement of the full knee joint. It is performed in an operating room, typically in a hospital or ambulatory surgery center. The operative report should identify the patellar procedure and the use of a prosthetic component.

Report this code for the patellar arthroplasty itself; patellar resurfacing performed as part of a total knee arthroplasty is included in that broader procedure. The service has 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%. When performed bilaterally with modifier 50, payment is at 150%. Assistant-at-surgery payment may be available; 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 27438 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

27438 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$707.49
Alaska*Unavailable$959.42
ArizonaUnavailable$760.50
ArkansasUnavailable$698.33
AtlantaUnavailable$804.41
AustinUnavailable$791.63
BakersfieldUnavailable$787.64
Baltimore/Surr. CntysUnavailable$830.24
BeaumontUnavailable$747.93
BrazoriaUnavailable$764.33

27438 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
27438 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 27438 rate is calculated

Each of 27438’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 · 27438

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 11.59Practice expense 9.39Malpractice 2.43

23.4100 adjusted RVUs×$33.4009 conversion factor=$781.92

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

Payment rules and modifiers for 27438

27438 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 27438

Patellar arthroplasty

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 · 27438

Patellar arthroplasty

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

27438 without 50 · national facility

$781.92

Patellar arthroplasty

27438-50 · Bilateral: 150%

$1,172.88

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

27438 compared with similar codes

Compare codes

27438 vs 27437 vs 27447 vs 27424: national Medicare rates

Swap in your local Medicare rate.

  • 27438
    Patellar arthroplasty · 11.59 wRVU
    —
  • 27437
    Patellar arthroplasty · 8.71 wRVU
    —
  • 27447
    Total knee replacement · 19.11 wRVU
    —
  • 27424
    Patella surgery · 9.98 wRVU
    —

How to choose

27437Patellar arthroplasty
Use 27438 when the patellar arthroplasty includes a prosthetic implant. Use 27437 when the patellar arthroplasty is performed without one.
27447Total knee replacement
Use 27447 for total knee arthroplasty. Do not separately report 27438 for patellar resurfacing performed as part of that replacement.
27424Patella surgery
This code is for patellar arthroplasty with a prosthetic implant. Code 27424 describes patellar removal rather than implant replacement.

Codes related to 27438

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

Codes related to 27438
CodeHow it relatesNational office range
Same family
27437Patellar arthroplastyPatellar arthroplasty without a prosthetic implant.No office rate
Used instead
27447Total knee replacementTotal knee arthroplasty replaces the knee joint more broadly; patellar resurfacing is included when performed.No office rate
27424Patella surgeryPatellar removal is a different operative approach when the patella is removed rather than replaced with an implant.No office rate

27438 billing questions

How is this different from 27437?

This code includes a prosthetic implant for the patella. Code 27437 is the corresponding patellar arthroplasty without a prosthesis.

Can this be reported separately with total knee arthroplasty?

No. Patellar resurfacing performed as part of total knee arthroplasty is included in the broader procedure; do not separately report this code for that work.

What documentation supports reporting this code?

The operative report should describe the patellar arthroplasty and identify the prosthetic component. It should also make clear whether the service was a standalone patellar procedure or part of a broader knee replacement.

How does the 90-day global period affect postoperative care?

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

How are bilateral procedures and multiple procedures in one session handled?

A bilateral procedure reported with modifier 50 is paid at 150%. For multiple procedures in the same session, the highest-valued procedure is paid in full and others at 50%.

Can an assistant or co-surgeon be reported?

Assistant-at-surgery payment may be available. 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 27438PPRRVU2026_Oct_nonQPP.csv, line 2,893 (RVU26D)

Open CMS sourceHow we calculate rates

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