No office rate
This related arthroplasty code includes debridement and partial synovectomy. Choose based on the operative service documented, not simply the diagnosis.
On this page
CMS RVU26D · Effective 2026-10-01
27442 Knee revision Medicare reimbursement rates
Reports operative revision arthroplasty of the knee joint, generally performed by an orthopedic surgeon when the joint requires reconstructive surgical treatment. Compare 27442 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 27442?
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 27442 pays more and less
Orthopedic surgery
About 27442: Knee joint arthroplasty revision
Reports operative revision arthroplasty of the knee joint, generally performed by an orthopedic surgeon when the joint requires reconstructive surgical treatment.
This code represents an operative revision arthroplasty involving the knee joint. An orthopedic surgeon typically performs the procedure in a hospital or ambulatory surgery facility, addressing a joint that needs reconstructive surgical treatment. The operative report should make clear what was revised and the work performed; a ligament reconstruction, patellar realignment, or routine primary total knee replacement is a different service.
Report the code when the documented operation supports this knee-joint revision service, rather than selecting it from the diagnosis alone. CMS assigns a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care 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. Bilateral reporting with 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 27442
- 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 RVU12.06 · 50%
- Practice expense (office) RVU9.51 · 39%
- Malpractice RVU2.53 · 10%
114
Medicare services in 2024 · #4777 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.
27442 compared with similar codes
Office rate ranges across all CMS payment localities, from the same CMS release.
No office rate
This code describes arthroplasty limited to the medial or lateral compartment. Use it when the operation meets that compartment-specific service rather than the revision service represented here.
No office rate
This code is for primary replacement of both knee compartments. It is not interchangeable with a revision procedure.
No office rate
This code identifies revision total knee arthroplasty involving one component. Use it when the documented operation meets that component-specific revision service.
See how rates vary across the country
27442 · 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 27442 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 $728.58 |
| Alaska* | Office Unavailable | Facility $989.07 |
| Arizona | Office Unavailable | Facility $782.95 |
| Arkansas | Office Unavailable | Facility $719.19 |
| Atlanta | Office Unavailable | Facility $828.24 |
| Austin | Office Unavailable | Facility $814.56 |
| Bakersfield | Office Unavailable | Facility $810.07 |
| Baltimore/Surr. Cntys | Office Unavailable | Facility $854.62 |
| Beaumont | Office Unavailable | Facility $770.37 |
| Brazoria | Office Unavailable | Facility $786.73 |
| Chicago | Office Unavailable | Facility $918.80 |
| Chico | Office Unavailable | Facility $803.09 |
| Colorado | Office Unavailable | Facility $811.62 |
| Connecticut | Office Unavailable | Facility $855.22 |
| Dallas | Office Unavailable | Facility $795.32 |
| Dc + Md/Va Suburbs | Office Unavailable | Facility $892.80 |
| Delaware | Office Unavailable | Facility $794.63 |
| Detroit | Office Unavailable | Facility $851.81 |
| East St. Louis | Office Unavailable | Facility $865.24 |
| El Centro | Office Unavailable | Facility $803.52 |
| Fort Lauderdale | Office Unavailable | Facility $877.37 |
| Fort Worth | Office Unavailable | Facility $793.24 |
| Fresno | Office Unavailable | Facility $803.09 |
| Galveston | Office Unavailable | Facility $791.43 |
| Hanford-Corcoran | Office Unavailable | Facility $803.09 |
| Hawaii, Guam | Office Unavailable | Facility $812.90 |
| Houston | Office Unavailable | Facility $837.73 |
| Idaho | Office Unavailable | Facility $735.02 |
| Indiana | Office Unavailable | Facility $738.34 |
| Iowa | Office Unavailable | Facility $727.01 |
| Kansas | Office Unavailable | Facility $732.55 |
| Kentucky | Office Unavailable | Facility $762.52 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Office Unavailable | Facility $851.21 |
| Madera | Office Unavailable | Facility $803.09 |
| Manhattan | Office Unavailable | Facility $931.72 |
| Merced | Office Unavailable | Facility $803.09 |
| Metropolitan Boston | Office Unavailable | Facility $873.80 |
| Metropolitan Kansas City | Office Unavailable | Facility $783.64 |
| Metropolitan Philadelphia | Office Unavailable | Facility $841.55 |
| Metropolitan St. Louis | Office Unavailable | Facility $789.88 |
| Miami | Office Unavailable | Facility $947.19 |
| Minnesota | Office Unavailable | Facility $754.68 |
| Mississippi | Office Unavailable | Facility $738.75 |
| Modesto | Office Unavailable | Facility $803.09 |
| Montana** | Office Unavailable | Facility $804.79 |
| Napa | Office Unavailable | Facility $889.77 |
| Nebraska | Office Unavailable | Facility $727.94 |
| Nevada** | Office Unavailable | Facility $791.17 |
| New Hampshire | Office Unavailable | Facility $807.42 |
| New Mexico | Office Unavailable | Facility $795.58 |
| New Orleans | Office Unavailable | Facility $797.71 |
| North Carolina | Office Unavailable | Facility $753.17 |
| North Dakota** | Office Unavailable | Facility $754.77 |
| Northern Nj | Office Unavailable | Facility $886.91 |
| Nyc Suburbs/Long Island | Office Unavailable | Facility $963.20 |
| Ohio | Office Unavailable | Facility $778.00 |
| Oklahoma | Office Unavailable | Facility $752.13 |
| Oxnard-Thousand Oaks-Ventura | Office Unavailable | Facility $842.19 |
| Portland | Office Unavailable | Facility $825.03 |
| Poughkpsie/N Nyc Suburbs | Office Unavailable | Facility $871.01 |
| Puerto Rico | Office Unavailable | Facility $807.19 |
| Queens | Office Unavailable | Facility $925.90 |
| Redding | Office Unavailable | Facility $803.09 |
| Rest Of California | Office Unavailable | Facility $803.09 |
| Rest Of Florida | Office Unavailable | Facility $833.49 |
| Rest Of Georgia | Office Unavailable | Facility $786.88 |
| Rest Of Illinois | Office Unavailable | Facility $824.90 |
| Rest Of Louisiana | Office Unavailable | Facility $764.88 |
| Rest Of Maine | Office Unavailable | Facility $747.61 |
| Rest Of Maryland | Office Unavailable | Facility $805.87 |
| Rest Of Massachusetts | Office Unavailable | Facility $811.09 |
| Rest Of Michigan | Office Unavailable | Facility $788.23 |
| Rest Of Missouri | Office Unavailable | Facility $758.93 |
| Rest Of New Jersey | Office Unavailable | Facility $858.49 |
| Rest Of New York | Office Unavailable | Facility $763.98 |
| Rest Of Oregon | Office Unavailable | Facility $778.59 |
| Rest Of Pennsylvania | Office Unavailable | Facility $774.27 |
| Rest Of Texas | Office Unavailable | Facility $780.57 |
| Rest Of Washington | Office Unavailable | Facility $806.84 |
| Rhode Island | Office Unavailable | Facility $813.97 |
| Riverside-San Bernardino-Ontario | Office Unavailable | Facility $830.28 |
| Sacramento-Roseville-Folsom | Office Unavailable | Facility $832.03 |
| Salinas | Office Unavailable | Facility $828.74 |
| San Diego-Chula Vista-Carlsbad | Office Unavailable | Facility $840.60 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Office Unavailable | Facility $927.75 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Office Unavailable | Facility $924.87 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Office Unavailable | Facility $950.46 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Office Unavailable | Facility $938.71 |
| San Luis Obispo-Paso Robles | Office Unavailable | Facility $816.75 |
| Santa Cruz-Watsonville | Office Unavailable | Facility $842.50 |
| Santa Maria-Santa Barbara | Office Unavailable | Facility $829.76 |
| Santa Rosa-Petaluma | Office Unavailable | Facility $850.26 |
| Seattle (King Cnty) | Office Unavailable | Facility $881.74 |
| South Carolina | Office Unavailable | Facility $768.15 |
| South Dakota** | Office Unavailable | Facility $748.85 |
| Southern Maine | Office Unavailable | Facility $770.92 |
| Stockton | Office Unavailable | Facility $803.09 |
| Suburban Chicago | Office Unavailable | Facility $881.60 |
| Tennessee | Office Unavailable | Facility $736.93 |
| Utah | Office Unavailable | Facility $777.28 |
| Vallejo | Office Unavailable | Facility $885.63 |
| Vermont | Office Unavailable | Facility $760.04 |
| Virgin Islands | Office Unavailable | Facility $807.19 |
| Virginia | Office Unavailable | Facility $774.72 |
| Visalia | Office Unavailable | Facility $803.09 |
| West Virginia | Office Unavailable | Facility $799.77 |
| Wisconsin | Office Unavailable | Facility $733.14 |
| Wyoming** | Office Unavailable | Facility $782.99 |
| Yuba City | Office Unavailable | Facility $803.09 |
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27442 billing questions
How is this code different from a total knee replacement?
This code represents revision arthroplasty of the knee joint. A primary replacement of both knee compartments is reported with 27447 when the operative service meets that code’s criteria.
Does the 90-day global period include postoperative visits?
Yes. Related postoperative care for 90 days is included, along with the preoperative visit on the day before surgery.
How are other procedures performed in the same session paid?
The highest-valued procedure is paid in full; other procedures are subject to the standard multiple-procedure reduction, with payment at 50%.
Can modifier 50 be used for bilateral surgery?
CMS identifies this as a bilateral procedure; reporting with modifier 50 is paid at 150%.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation, and team surgery is not permitted.
What should the operative report establish?
Document the knee-joint revision performed and the operative work supporting this service. The diagnosis by itself does not establish which procedure code applies.
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.
2,89327438,,Revise kneecap with implant,A,,11.59,9.39,NA,9.39,,2.43,23.41,23.41,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,89427440,,Revision of knee joint,A,,10.81,9.21,NA,9.21,,2.31,22.33,22.33,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,89527441,,Revision of knee joint,A,,11.25,9.36,NA,9.36,,2.40,23.01,23.01,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,89627442,,Revision of knee joint,A,,12.06,9.51,NA,9.51,,2.53,24.10,24.10,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,89727443,,Revision of knee joint,A,,11.12,9.32,NA,9.32,,2.37,22.81,22.81,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,89827446,,Revision of knee joint,A,,16.70,11.13,NA,11.13,,3.53,31.36,31.36,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,89927447,,Total knee arthroplasty,A,,19.11,11.58,NA,11.58,,4.02,34.71,34.71,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00