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Billing code 27488: Knee prosthesis removalMedicare rate & RVUs

Reports operative removal of a knee prosthesis, with or without placement of a spacer, such as during staged treatment of prosthetic joint infection.

CMS RVU26DEffective Oct 1, 2026109 payment localities3.6K Medicare services in 2024

Medicare pays $1,099.89 for 27488 nationally in a facility.

Medicare rate · 27488

Knee prosthesis removal

Swap in your local Medicare rate.

Work RVUs
17.16
Total RVUs
32.93
Global days
090

National rate · 2026

$1,099.89

Facility setting, before claim adjustments.

See every locality for 27488 → · 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 27488 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 27488 covers

An orthopedic surgeon removes implanted knee prosthetic components and associated cement when the treatment plan calls for explantation rather than definitive revision at that operation. A typical situation is the first stage of treating an infected knee replacement, when components are removed and a temporary spacer may be placed. The service is generally performed in an operating room, often in a hospital facility.

Select this code when the operative work is removal of the knee prosthesis, with or without spacer placement; a definitive revision replacing one or both components is represented by a different service. The operative report should identify the indication, components removed, and whether a spacer was inserted. This major surgery has a 90-day global period, including the day-before preoperative visit and related postoperative care. For same-session procedures, the highest-valued procedure is paid in full and others at 50%. 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 27488 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

27488 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$996.59
Alaska*Unavailable$1,358.39
ArizonaUnavailable$1,069.86
ArkansasUnavailable$983.91
AtlantaUnavailable$1,132.47
AustinUnavailable$1,110.73
BakersfieldUnavailable$1,102.30
Baltimore/Surr. CntysUnavailable$1,167.40
BeaumontUnavailable$1,054.79
BrazoriaUnavailable$1,074.15

27488 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.

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View every state and territory as a table
27488 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 27488 rate is calculated

Each of 27488’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 · 27488

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 17.16Practice expense 12.14Malpractice 3.63

32.9300 adjusted RVUs×$33.4009 conversion factor=$1,099.89

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

Payment rules and modifiers for 27488

27488 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 27488

Knee prosthesis removal

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 · 27488

Knee prosthesis removal

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

27488 without 50 · national facility

$1,099.89

Knee prosthesis removal

27488-50 · Bilateral: 150%

$1,649.84

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

27488 compared with similar codes

Compare codes

27488 vs 27486 vs 27487 vs 27447: national Medicare rates

Swap in your local Medicare rate.

  • 27488
    Knee prosthesis removal · 17.16 wRVU
    —
  • 27486
    Knee revision · 20.59 wRVU
    —
  • 27487
    Knee revision · 26.43 wRVU
    —
  • 27447
    Total knee replacement · 19.11 wRVU
    —

How to choose

27486Knee revision
27488 reports removal of the knee prosthesis, with or without a spacer. Use 27486 when the operation revises or replaces one component.
27487Knee revision
27488 is for prosthesis removal rather than definitive revision. Use 27487 when both knee components are revised or replaced.
27447Total knee replacement
27447 describes primary total knee replacement. It is not the code for removing an existing prosthesis during staged treatment.

Codes related to 27488

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

Codes related to 27488
CodeHow it relatesNational office range
Used instead
27486Knee revisionUsed for revision involving one knee prosthetic component rather than prosthesis removal.No office rate
27487Knee revisionUsed for revision involving both knee prosthetic components rather than prosthesis removal.No office rate
27447Total knee replacementPrimary total knee replacement, not removal of an existing prosthesis.No office rate

27488 billing questions

How does this differ from a knee revision code?

Use 27488 for prosthesis removal, with or without spacer placement, rather than definitive component revision. Codes 27486 and 27487 describe revision or replacement of one or both components.

Can a spacer be placed during the removal?

Yes. Spacer placement may accompany the prosthesis removal reported with 27488.

What should the operative report document?

Document the reason for explantation, which prosthetic components were removed, and whether a spacer was inserted. The record should make clear whether the operation was removal or definitive revision.

What is the global period?

This major surgery has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care.

How is bilateral reporting handled?

When the procedure is performed bilaterally, modifier 50 is paid at 150% under the CMS facts for this code.

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 27488PPRRVU2026_Oct_nonQPP.csv, line 2,916 (RVU26D)

Open CMS sourceHow we calculate rates

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