No office rate
27427 is for extra-articular knee ligament reconstruction. 27428 applies when the reconstruction is intra-articular.
On this page
CMS RVU26D · Effective 2026-10-01
27428 in Merced
Office / nonfacility
Not available in this setting
Base rate per service
Facility setting
$1039.82
Base rate per service
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.
Orthopedic surgery
About 27428: Intra-articular knee ligament reconstruction
Report this procedure for surgical reconstruction of an intra-articular knee ligament, commonly a cruciate ligament, when reconstruction rather than direct repair is performed.
This service reconstructs a ligament within the knee joint, commonly a cruciate ligament, to restore stability when the ligament cannot be adequately treated with direct repair. An orthopedic surgeon performs the reconstruction in an operating room, typically using a graft to replace or augment the deficient ligament. The operative report should identify the ligament treated, the intra-articular reconstruction performed, and the reason reconstruction was selected.
Report 27428 for the intra-articular portion of the reconstruction; use the related code for an extra-articular reconstruction or for a procedure combining both locations. The day-before preoperative visit and 90 days of related postoperative care are included in the major-surgery global period. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and others at 50%. Modifier 50 identifies a bilateral procedure, 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 27428
- 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 RVU15.19 · 49%
- Practice expense (office) RVU12.73 · 41%
- Malpractice RVU3.23 · 10%
63
Medicare services in 2024 · #5208 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.
27428 compared with similar codes
Office rates for Merced, from the same CMS release.
No office rate
27429 describes reconstruction involving both intra-articular and extra-articular work; 27428 describes the intra-articular reconstruction.
No office rate
27407 is for knee ligament repair. Choose 27428 when the documented procedure reconstructs an intra-articular ligament instead.
No office rate
29888 is for arthroscopically aided ACL repair, augmentation, or reconstruction. 27428 describes intra-articular knee ligament reconstruction outside that arthroscopically aided ACL code.
The same code, a different location
How does Merced compare?
27428 across payment areas
Same release and payment basis · bars start at $0
Merced · This locality
Unavailable
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
No comparable rate is available in this setting.
Other payment areas listed in California appear first, followed by selected cross-country examples. The chart compares amounts, not distance.
The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.
Compare all 108 other payment areas
Madera
California · 27428
Office
Unavailable
Facility
$1039.82
No comparable office rate is available.
Modesto
California · 27428
Office
Unavailable
Facility
$1039.82
No comparable office rate is available.
Napa
California · 27428
Office
Unavailable
Facility
$1154.53
No comparable office rate is available.
Oxnard-Thousand Oaks-Ventura
California · 27428
Office
Unavailable
Facility
$1091.36
No comparable office rate is available.
Redding
California · 27428
Office
Unavailable
Facility
$1039.82
No comparable office rate is available.
Rest Of California
California · 27428
Office
Unavailable
Facility
$1039.82
No comparable office rate is available.
Riverside-San Bernardino-Ontario
California · 27428
Office
Unavailable
Facility
$1074.53
No comparable office rate is available.
Sacramento-Roseville-Folsom
California · 27428
Office
Unavailable
Facility
$1077.95
No comparable office rate is available.
Salinas
California · 27428
Office
Unavailable
Facility
$1073.71
No comparable office rate is available.
San Diego-Chula Vista-Carlsbad
California · 27428
Office
Unavailable
Facility
$1089.59
No comparable office rate is available.
San Francisco-Oakland-Berkeley (Marin Cnty)
California · 27428
Office
Unavailable
Facility
$1204.60
No comparable office rate is available.
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)
California · 27428
Office
Unavailable
Facility
$1200.93
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
California · 27428
Office
Unavailable
Facility
$1234.12
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
California · 27428
Office
Unavailable
Facility
$1219.13
No comparable office rate is available.
San Luis Obispo-Paso Robles
California · 27428
Office
Unavailable
Facility
$1058.11
No comparable office rate is available.
Santa Cruz-Watsonville
California · 27428
Office
Unavailable
Facility
$1092.45
No comparable office rate is available.
Santa Maria-Santa Barbara
California · 27428
Office
Unavailable
Facility
$1075.17
No comparable office rate is available.
Santa Rosa-Petaluma
California · 27428
Office
Unavailable
Facility
$1102.54
No comparable office rate is available.
Stockton
California · 27428
Office
Unavailable
Facility
$1039.82
No comparable office rate is available.
Vallejo
California · 27428
Office
Unavailable
Facility
$1149.25
No comparable office rate is available.
Visalia
California · 27428
Office
Unavailable
Facility
$1039.82
No comparable office rate is available.
Yuba City
California · 27428
Office
Unavailable
Facility
$1039.82
No comparable office rate is available.
Dc + Md/Va Suburbs
District of Columbia · 27428
Office
Unavailable
Facility
$1155.71
No comparable office rate is available.
Miami
Florida · 27428
Office
Unavailable
Facility
$1222.83
No comparable office rate is available.
Chicago
Illinois · 27428
Office
Unavailable
Facility
$1185.83
No comparable office rate is available.
Manhattan
New York · 27428
Office
Unavailable
Facility
$1205.01
No comparable office rate is available.
Alaska*
Alaska · 27428
Office
Unavailable
Facility
$1273.32
No comparable office rate is available.
Alabama
Alabama · 27428
Office
Unavailable
Facility
$940.47
No comparable office rate is available.
Arkansas
Arkansas · 27428
Office
Unavailable
Facility
$928.16
No comparable office rate is available.
Arizona
Arizona · 27428
Office
Unavailable
Facility
$1011.72
No comparable office rate is available.
Colorado
Colorado · 27428
Office
Unavailable
Facility
$1050.11
No comparable office rate is available.
Connecticut
Connecticut · 27428
Office
Unavailable
Facility
$1105.98
No comparable office rate is available.
Delaware
Delaware · 27428
Office
Unavailable
Facility
$1026.98
No comparable office rate is available.
Fort Lauderdale
Florida · 27428
Office
Unavailable
Facility
$1133.14
No comparable office rate is available.
Rest Of Florida
Florida · 27428
Office
Unavailable
Facility
$1076.00
No comparable office rate is available.
Atlanta
Georgia · 27428
Office
Unavailable
Facility
$1070.45
No comparable office rate is available.
Rest Of Georgia
Georgia · 27428
Office
Unavailable
Facility
$1015.23
No comparable office rate is available.
Hawaii, Guam
Hawaii · 27428
Office
Unavailable
Facility
$1053.27
No comparable office rate is available.
Iowa
Iowa · 27428
Office
Unavailable
Facility
$939.24
No comparable office rate is available.
Idaho
Idaho · 27428
Office
Unavailable
Facility
$949.57
No comparable office rate is available.
East St. Louis
Illinois · 27428
Office
Unavailable
Facility
$1115.82
No comparable office rate is available.
Rest Of Illinois
Illinois · 27428
Office
Unavailable
Facility
$1064.19
No comparable office rate is available.
Suburban Chicago
Illinois · 27428
Office
Unavailable
Facility
$1138.76
No comparable office rate is available.
Indiana
Indiana · 27428
Office
Unavailable
Facility
$953.95
No comparable office rate is available.
Kansas
Kansas · 27428
Office
Unavailable
Facility
$946.11
No comparable office rate is available.
Kentucky
Kentucky · 27428
Office
Unavailable
Facility
$984.07
No comparable office rate is available.
New Orleans
Louisiana · 27428
Office
Unavailable
Facility
$1030.02
No comparable office rate is available.
Rest Of Louisiana
Louisiana · 27428
Office
Unavailable
Facility
$987.01
No comparable office rate is available.
Metropolitan Boston
Massachusetts · 27428
Office
Unavailable
Facility
$1131.86
No comparable office rate is available.
Rest Of Massachusetts
Massachusetts · 27428
Office
Unavailable
Facility
$1049.19
No comparable office rate is available.
Baltimore/Surr. Cntys
Maryland · 27428
Office
Unavailable
Facility
$1105.16
No comparable office rate is available.
Rest Of Maryland
Maryland · 27428
Office
Unavailable
Facility
$1041.77
No comparable office rate is available.
Rest Of Maine
Maine · 27428
Office
Unavailable
Facility
$965.64
No comparable office rate is available.
Southern Maine
Maine · 27428
Office
Unavailable
Facility
$996.80
No comparable office rate is available.
Detroit
Michigan · 27428
Office
Unavailable
Facility
$1099.57
No comparable office rate is available.
Rest Of Michigan
Michigan · 27428
Office
Unavailable
Facility
$1017.36
No comparable office rate is available.
Minnesota
Minnesota · 27428
Office
Unavailable
Facility
$976.82
No comparable office rate is available.
Metropolitan Kansas City
Missouri · 27428
Office
Unavailable
Facility
$1012.02
No comparable office rate is available.
Metropolitan St. Louis
Missouri · 27428
Office
Unavailable
Facility
$1020.24
No comparable office rate is available.
Rest Of Missouri
Missouri · 27428
Office
Unavailable
Facility
$978.96
No comparable office rate is available.
Mississippi
Mississippi · 27428
Office
Unavailable
Facility
$953.18
No comparable office rate is available.
Montana**
Montana · 27428
Office
Unavailable
Facility
$1040.22
No comparable office rate is available.
North Carolina
North Carolina · 27428
Office
Unavailable
Facility
$973.00
No comparable office rate is available.
North Dakota**
North Dakota · 27428
Office
Unavailable
Facility
$976.35
No comparable office rate is available.
Nebraska
Nebraska · 27428
Office
Unavailable
Facility
$940.59
No comparable office rate is available.
New Hampshire
New Hampshire · 27428
Office
Unavailable
Facility
$1044.39
No comparable office rate is available.
Northern Nj
New Jersey · 27428
Office
Unavailable
Facility
$1147.77
No comparable office rate is available.
Rest Of New Jersey
New Jersey · 27428
Office
Unavailable
Facility
$1110.32
No comparable office rate is available.
New Mexico
New Mexico · 27428
Office
Unavailable
Facility
$1026.83
No comparable office rate is available.
Nevada**
Nevada · 27428
Office
Unavailable
Facility
$1022.85
No comparable office rate is available.
Nyc Suburbs/Long Island
New York · 27428
Office
Unavailable
Facility
$1245.73
No comparable office rate is available.
Poughkpsie/N Nyc Suburbs
New York · 27428
Office
Unavailable
Facility
$1126.32
No comparable office rate is available.
Queens
New York · 27428
Office
Unavailable
Facility
$1197.98
No comparable office rate is available.
Rest Of New York
New York · 27428
Office
Unavailable
Facility
$987.14
No comparable office rate is available.
Ohio
Ohio · 27428
Office
Unavailable
Facility
$1004.31
No comparable office rate is available.
Oklahoma
Oklahoma · 27428
Office
Unavailable
Facility
$970.88
No comparable office rate is available.
Portland
Oregon · 27428
Office
Unavailable
Facility
$1068.13
No comparable office rate is available.
Rest Of Oregon
Oregon · 27428
Office
Unavailable
Facility
$1006.70
No comparable office rate is available.
Metropolitan Philadelphia
Pennsylvania · 27428
Office
Unavailable
Facility
$1087.83
No comparable office rate is available.
Rest Of Pennsylvania
Pennsylvania · 27428
Office
Unavailable
Facility
$999.64
No comparable office rate is available.
Puerto Rico
Puerto Rico · 27428
Office
Unavailable
Facility
$1043.50
No comparable office rate is available.
Rhode Island
Rhode Island · 27428
Office
Unavailable
Facility
$1052.46
No comparable office rate is available.
South Carolina
South Carolina · 27428
Office
Unavailable
Facility
$991.94
No comparable office rate is available.
South Dakota**
South Dakota · 27428
Office
Unavailable
Facility
$968.80
No comparable office rate is available.
Tennessee
Tennessee · 27428
Office
Unavailable
Facility
$951.79
No comparable office rate is available.
Austin
Texas · 27428
Office
Unavailable
Facility
$1053.82
No comparable office rate is available.
Beaumont
Texas · 27428
Office
Unavailable
Facility
$994.51
No comparable office rate is available.
Brazoria
Texas · 27428
Office
Unavailable
Facility
$1016.94
No comparable office rate is available.
Dallas
Texas · 27428
Office
Unavailable
Facility
$1027.98
No comparable office rate is available.
Fort Worth
Texas · 27428
Office
Unavailable
Facility
$1025.13
No comparable office rate is available.
Galveston
Texas · 27428
Office
Unavailable
Facility
$1022.96
No comparable office rate is available.
Houston
Texas · 27428
Office
Unavailable
Facility
$1082.09
No comparable office rate is available.
Rest Of Texas
Texas · 27428
Office
Unavailable
Facility
$1008.29
No comparable office rate is available.
Utah
Utah · 27428
Office
Unavailable
Facility
$1003.92
No comparable office rate is available.
Virginia
Virginia · 27428
Office
Unavailable
Facility
$1001.49
No comparable office rate is available.
Virgin Islands
United States Virgin Islands · 27428
Office
Unavailable
Facility
$1043.50
No comparable office rate is available.
Vermont
Vermont · 27428
Office
Unavailable
Facility
$982.89
No comparable office rate is available.
Rest Of Washington
Washington · 27428
Office
Unavailable
Facility
$1043.78
No comparable office rate is available.
Seattle (King Cnty)
Washington · 27428
Office
Unavailable
Facility
$1142.58
No comparable office rate is available.
Wisconsin
Wisconsin · 27428
Office
Unavailable
Facility
$947.92
No comparable office rate is available.
West Virginia
West Virginia · 27428
Office
Unavailable
Facility
$1031.24
No comparable office rate is available.
Wyoming**
Wyoming · 27428
Office
Unavailable
Facility
$1012.39
No comparable office rate is available.
See how rates vary across the country
27428 · 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 |
Where does this rate apply?
Merced is a Medicare payment area. Our Census mapping connects it to 24 cities and communities in California, including the examples shown here.
Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.
Use this rate
What is a percentage of Medicare worth?
Turn a percentage into dollars for 27428 in Merced. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$1143.80
$1039.82 × 110% = $1143.80
A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.
Working with a whole code list?
Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.
How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 27428 in Merced.
PPRRVU2026_Oct_nonQPP.csv
2,888
- Code
- 27428
- Physician work
- 15.19
- Practice expense
- 12.73
- Malpractice
- 3.23
GPCI2026.csv
15
- Locality
- Merced
- Physician work
- 1.017
- Practice expense
- 1.096
- Malpractice
- 0.536
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 15.19 | × 1.017 | 15.4482 |
| Practice expense | 12.73 | × 1.096 | 13.9521 |
| Malpractice | 3.23 | × 0.536 | 1.7313 |
| Total RVUs | 31.1316 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Merced$1039.82
Open 27428 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 15.19 | 1.017 |
| Practice expense | 12.73 | 1.096 |
| Malpractice | 3.23 | 0.536 |
(15.19 × 1.017 + 12.73 × 1.096 + 3.23 × 0.536) × $33.4009 = $1039.82
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
How this rate has changed
27428 · Office / nonfacility
Rate unavailable
Effective 2026-10-01
A rate is unavailable in one of these releases, so a change cannot be calculated.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
What changed, release by release
Explore release dates and calculate this code in an earlier period →
Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.
Inspect every release and its CMS source
| Effective from | Office / nonfacility | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $1039.82 | RVU26D |
| 2026-07-01 | Not available in this setting | $1039.82 | RVU26C |
| 2026-04-01 | Not available in this setting | $1039.82 | RVU26B |
| 2026-01-01 | Not available in this setting | $1039.82 | RVU26A |
| 2025-10-01 | Not available in this setting | $1112.54 | RVU25D |
| 2025-07-01 | Not available in this setting | $1112.54 | RVU25C |
| 2025-04-01 | Not available in this setting | $1112.54 | RVU25B |
| 2025-01-01 | Not available in this setting | $1112.54 | RVU25A |
27428 billing questions
How is 27428 distinguished from 27427 and 27429?
Use 27428 for an intra-articular ligament reconstruction. Code 27427 describes an extra-articular reconstruction, while 27429 describes reconstruction involving both intra-articular and extra-articular work.
When is reconstruction reported instead of 27407?
Code 27428 describes intra-articular reconstruction, commonly involving a graft. Code 27407 is for repair of a knee ligament, rather than this intra-articular reconstruction.
What documentation supports 27428?
The operative report should identify the ligament reconstructed, document the intra-articular work, and explain the reconstruction performed. It should distinguish that work from direct ligament repair or an extra-articular procedure.
Does the 90-day global period include postoperative visits?
Yes. The major-surgery global period includes the day-before preoperative visit and 90 days of related postoperative care.
How are bilateral procedures and additional same-session procedures handled?
Modifier 50 identifies a bilateral procedure, which is paid at 150%. For multiple procedures in one session, the highest-valued procedure is paid in full and the others at 50%.
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.
2,88527424,,Revision/removal of kneecap,A,,9.98,8.97,NA,8.97,,2.13,21.08,21.08,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,88627425,,Lat retinacular release open,A,,5.26,6.89,NA,6.89,,1.11,13.26,13.26,0,090,0.10,0.69,0.21,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,88727427,,Reconstruction knee,A,,9.55,8.42,NA,8.42,,1.87,19.84,19.84,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,88827428,,Reconstruction knee,A,,15.19,12.73,NA,12.73,,3.23,31.15,31.15,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,88927429,,Reconstruction knee,A,,17.10,14.35,NA,14.35,,3.64,35.09,35.09,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,89027430,,Revision of thigh muscles,A,,9.91,8.92,NA,8.92,,2.10,20.93,20.93,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,89127435,,Incision of knee joint,A,,10.61,9.95,NA,9.95,,2.21,22.77,22.77,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1201112,CA,57,HANFORD-CORCORAN,1.017,1.096,0.536
1301182,CA,18,LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY),1.041,1.183,0.664
1401112,CA,58,MADERA,1.017,1.096,0.536
1501112,CA,59,MERCED,1.017,1.096,0.536
1601112,CA,60,MODESTO,1.017,1.096,0.536
1701112,CA,51,NAPA,1.063,1.318,0.508
1801182,CA,17,OXNARD-THOUSAND OAKS-VENTURA,1.028,1.182,0.623