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Billing code 27486: Knee revisionMedicare rate & RVUs

Reports revision of an existing total knee replacement when the surgeon revises one prosthetic component, such as for loosening, wear, or instability.

CMS RVU26DEffective Oct 1, 2026109 payment localities16.3K Medicare services in 2024

Medicare pays $1,274.91 for 27486 nationally in a facility.

Medicare rate · 27486

Knee revision

Work RVUs
20.59
Total RVUs
38.17
Global days
090

National rate · 2026

$1,274.91

Facility setting, before claim adjustments.

See every locality for 27486 →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 27486 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 27486 covers

An orthopedic surgeon uses this code when revising one component of an existing total knee replacement, such as a femoral or tibial component. Typical reasons include component loosening, wear, or instability. The operation may include removing the old component and placing its replacement; the code also covers use of allograft. These revisions are generally performed in an operating room, usually in a hospital or ambulatory surgery setting.

Select this code when the operative report supports revision of one component, rather than revision of both components. Document the existing prosthesis, the component revised, the reason for revision, and the work performed. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed 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%. 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 27486 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

27486 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$1,156.62
Alaska*Unavailable$1,582.26
ArizonaUnavailable$1,240.29
ArkansasUnavailable$1,142.14
AtlantaUnavailable$1,313.25
AustinUnavailable$1,285.35
BakersfieldUnavailable$1,273.59
Baltimore/Surr. CntysUnavailable$1,352.61
BeaumontUnavailable$1,224.83
BrazoriaUnavailable$1,244.47

27486 rates by state

Office rate range in each state. Select a state to see its payment localities.

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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
27486 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 27486 rate is calculated

Each of 27486’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 · 27486

RVUs × geographic indexes × conversion factor

Work20.59

20.59 RVUs× 1.000 GPCI

Practice expense13.23

13.23 RVUs× 1.000 GPCI

Malpractice4.35

4.35 RVUs× 1.000 GPCI

Adjusted RVUs

38.1700

Conversion factor

$33.4009

Medicare rate

$1,274.91

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 27486

27486 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 27486

Knee revision

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 · 27486

Knee revision

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.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned 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

27486 without 50 · national facility

$1,274.91

Knee revision

27486-50 · Bilateral: 150%

$1,912.37

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

27486 compared with similar codes

Compare codes · National

5 codes, side by side

  • 27486

    Knee revision20.59 wRVU

    Not priced

  • 27487

    Knee revision26.43 wRVU

    Not priced

  • 27447

    Total knee replacement19.11 wRVU

    Not priced

  • 27488

    Knee prosthesis removal17.16 wRVU

    Not priced

  • 27446

    Partial knee replacement16.7 wRVU

    Not priced

How to choose

27487Knee revision
This code is for revision of one prosthetic component; 27487 is for revision of both components.
27447Total knee replacement
Use 27447 for primary total knee replacement. This code is for revising one component of an existing total knee prosthesis.
27488Knee prosthesis removal
Use 27488 when the knee prosthesis is removed without replacement. This code describes revision and replacement of one component.
27446Partial knee replacement
Code 27446 describes primary partial knee arthroplasty. This code applies to revision of one component in an existing total knee prosthesis.

Codes related to 27486

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

Codes related to 27486
CodeHow it relatesNational office range
Same family
27487Knee revisionRevision of both knee prosthetic components, rather than one.No office rate
Used instead
27447Total knee replacementPrimary total knee replacement when revising an existing prosthesis is not the service.No office rate
27488Knee prosthesis removalRemoval of a knee prosthesis when it is not replaced.No office rate
27446Partial knee replacementPrimary partial knee arthroplasty, not revision of one component of a total knee prosthesis.No office rate

27486 billing questions

How do I distinguish this code from 27487?

Use this code when one prosthetic component is revised. Code 27487 describes revision of both components.

Can removal of the old component be billed separately?

Removal performed as part of replacing the component is part of the revision service. Code 27488 is for removal of a knee prosthesis without replacement.

Does allograft use change the code selection?

No. This code covers revision of one component with or without allograft; the component count remains the key distinction.

What documentation supports reporting this code?

The operative report should identify the existing knee prosthesis, the single component revised, the reason for revision, and the work performed.

How is bilateral reporting handled?

For a bilateral procedure reported with modifier 50, CMS pays 150% under the supplied fee schedule rule.

Can an assistant or co-surgeon be reported?

Assistant-at-surgery payment may be made. 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 27486PPRRVU2026_Oct_nonQPP.csv, line 2,914 (RVU26D)

Open CMS sourceHow we calculate rates

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