No office rate
Both address a dislocating patella. Choose 27422 when the operative reconstruction includes extensor realignment, muscle advancement, or imbrication; 27420 represents the related reconstruction without those elements.
On this page
CMS RVU26D · Effective 2026-10-01
27422 in Wyoming**
Office / nonfacility
Not available in this setting
Base rate per service
Facility setting
$680.68
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 27422: Patellar instability reconstruction with realignment
Reports operative reconstruction for a dislocating kneecap when treatment includes extensor-mechanism realignment, muscle advancement, or imbrication.
An orthopedic surgeon uses this service to surgically address recurrent patellar instability, such as a kneecap that repeatedly slips out of position. The reconstruction includes realignment of the extensor mechanism, muscle advancement, or imbrication as part of stabilizing the patella. It is typically performed in a hospital or ambulatory surgery setting; CMS recorded these services in facility settings in 2024.
Choose this code when the operative report supports the instability reconstruction and the added realignment or muscle work, rather than a soft-tissue reconstruction without those elements. Document the affected knee, the instability being treated, and the structures and techniques used. Medicare assigns 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%. Bilateral reporting with modifier 50 is paid at 150%. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 27422
- 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 RVU9.95 · 48%
- Practice expense (office) RVU8.89 · 42%
- Malpractice RVU2.08 · 10%
742
Medicare services in 2024 · #3214 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.
27422 compared with similar codes
Office rates for Wyoming**, from the same CMS release.
No office rate
This code concerns anterior tibial tubercle reconstruction. Code 27422 is for patellar-instability reconstruction with extensor realignment or muscle work.
No office rate
Code 27425 represents open lateral retinacular release. It is not the broader patellar-instability reconstruction with extensor realignment reported under 27422.
The same code, a different location
How does Wyoming** compare?
27422 across payment areas
Same release and payment basis · bars start at $0
Wyoming** · This locality
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.
Unavailable
No comparable rate is available in this setting.
Other payment areas listed in Wyoming 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
Alabama
Alabama · 27422
Office
Unavailable
Facility
$631.48
No comparable office rate is available.
Arkansas
Arkansas · 27422
Office
Unavailable
Facility
$623.18
No comparable office rate is available.
Arizona
Arizona · 27422
Office
Unavailable
Facility
$679.54
No comparable office rate is available.
Bakersfield
California · 27422
Office
Unavailable
Facility
$706.40
No comparable office rate is available.
Chico
California · 27422
Office
Unavailable
Facility
$700.67
No comparable office rate is available.
El Centro
California · 27422
Office
Unavailable
Facility
$701.01
No comparable office rate is available.
Fresno
California · 27422
Office
Unavailable
Facility
$700.67
No comparable office rate is available.
Hanford-Corcoran
California · 27422
Office
Unavailable
Facility
$700.67
No comparable office rate is available.
Madera
California · 27422
Office
Unavailable
Facility
$700.67
No comparable office rate is available.
Merced
California · 27422
Office
Unavailable
Facility
$700.67
No comparable office rate is available.
Modesto
California · 27422
Office
Unavailable
Facility
$700.67
No comparable office rate is available.
Napa
California · 27422
Office
Unavailable
Facility
$779.93
No comparable office rate is available.
Oxnard-Thousand Oaks-Ventura
California · 27422
Office
Unavailable
Facility
$735.90
No comparable office rate is available.
Redding
California · 27422
Office
Unavailable
Facility
$700.67
No comparable office rate is available.
Rest Of California
California · 27422
Office
Unavailable
Facility
$700.67
No comparable office rate is available.
Riverside-San Bernardino-Ontario
California · 27422
Office
Unavailable
Facility
$723.02
No comparable office rate is available.
Sacramento-Roseville-Folsom
California · 27422
Office
Unavailable
Facility
$726.88
No comparable office rate is available.
Salinas
California · 27422
Office
Unavailable
Facility
$724.03
No comparable office rate is available.
San Diego-Chula Vista-Carlsbad
California · 27422
Office
Unavailable
Facility
$735.10
No comparable office rate is available.
San Francisco-Oakland-Berkeley (Marin Cnty)
California · 27422
Office
Unavailable
Facility
$814.48
No comparable office rate is available.
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)
California · 27422
Office
Unavailable
Facility
$812.11
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
California · 27422
Office
Unavailable
Facility
$834.31
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
California · 27422
Office
Unavailable
Facility
$824.66
No comparable office rate is available.
San Luis Obispo-Paso Robles
California · 27422
Office
Unavailable
Facility
$713.43
No comparable office rate is available.
Santa Cruz-Watsonville
California · 27422
Office
Unavailable
Facility
$737.33
No comparable office rate is available.
Santa Maria-Santa Barbara
California · 27422
Office
Unavailable
Facility
$725.11
No comparable office rate is available.
Santa Rosa-Petaluma
California · 27422
Office
Unavailable
Facility
$744.18
No comparable office rate is available.
Stockton
California · 27422
Office
Unavailable
Facility
$700.67
No comparable office rate is available.
Vallejo
California · 27422
Office
Unavailable
Facility
$776.52
No comparable office rate is available.
Visalia
California · 27422
Office
Unavailable
Facility
$700.67
No comparable office rate is available.
Yuba City
California · 27422
Office
Unavailable
Facility
$700.67
No comparable office rate is available.
Colorado
Colorado · 27422
Office
Unavailable
Facility
$706.52
No comparable office rate is available.
Connecticut
Connecticut · 27422
Office
Unavailable
Facility
$742.85
No comparable office rate is available.
Delaware
Delaware · 27422
Office
Unavailable
Facility
$689.83
No comparable office rate is available.
Fort Lauderdale
Florida · 27422
Office
Unavailable
Facility
$758.74
No comparable office rate is available.
Rest Of Florida
Florida · 27422
Office
Unavailable
Facility
$720.63
No comparable office rate is available.
Atlanta
Georgia · 27422
Office
Unavailable
Facility
$718.46
No comparable office rate is available.
Rest Of Georgia
Georgia · 27422
Office
Unavailable
Facility
$680.02
No comparable office rate is available.
Hawaii, Guam
Hawaii · 27422
Office
Unavailable
Facility
$710.18
No comparable office rate is available.
Iowa
Iowa · 27422
Office
Unavailable
Facility
$631.61
No comparable office rate is available.
Idaho
Idaho · 27422
Office
Unavailable
Facility
$638.38
No comparable office rate is available.
East St. Louis
Illinois · 27422
Office
Unavailable
Facility
$745.44
No comparable office rate is available.
Rest Of Illinois
Illinois · 27422
Office
Unavailable
Facility
$712.03
No comparable office rate is available.
Suburban Chicago
Illinois · 27422
Office
Unavailable
Facility
$762.72
No comparable office rate is available.
Indiana
Indiana · 27422
Office
Unavailable
Facility
$641.36
No comparable office rate is available.
Kansas
Kansas · 27422
Office
Unavailable
Facility
$635.78
No comparable office rate is available.
Kentucky
Kentucky · 27422
Office
Unavailable
Facility
$659.88
No comparable office rate is available.
New Orleans
Louisiana · 27422
Office
Unavailable
Facility
$690.68
No comparable office rate is available.
Rest Of Louisiana
Louisiana · 27422
Office
Unavailable
Facility
$661.68
No comparable office rate is available.
Metropolitan Boston
Massachusetts · 27422
Office
Unavailable
Facility
$762.34
No comparable office rate is available.
Rest Of Massachusetts
Massachusetts · 27422
Office
Unavailable
Facility
$705.70
No comparable office rate is available.
Baltimore/Surr. Cntys
Maryland · 27422
Office
Unavailable
Facility
$742.21
No comparable office rate is available.
Rest Of Maryland
Maryland · 27422
Office
Unavailable
Facility
$699.94
No comparable office rate is available.
Rest Of Maine
Maine · 27422
Office
Unavailable
Facility
$648.73
No comparable office rate is available.
Southern Maine
Maine · 27422
Office
Unavailable
Facility
$670.44
No comparable office rate is available.
Detroit
Michigan · 27422
Office
Unavailable
Facility
$736.01
No comparable office rate is available.
Rest Of Michigan
Michigan · 27422
Office
Unavailable
Facility
$681.88
No comparable office rate is available.
Minnesota
Minnesota · 27422
Office
Unavailable
Facility
$658.45
No comparable office rate is available.
Metropolitan Kansas City
Missouri · 27422
Office
Unavailable
Facility
$679.04
No comparable office rate is available.
Metropolitan St. Louis
Missouri · 27422
Office
Unavailable
Facility
$684.63
No comparable office rate is available.
Rest Of Missouri
Missouri · 27422
Office
Unavailable
Facility
$655.96
No comparable office rate is available.
Mississippi
Mississippi · 27422
Office
Unavailable
Facility
$639.34
No comparable office rate is available.
Montana**
Montana · 27422
Office
Unavailable
Facility
$698.61
No comparable office rate is available.
North Carolina
North Carolina · 27422
Office
Unavailable
Facility
$653.77
No comparable office rate is available.
North Dakota**
North Dakota · 27422
Office
Unavailable
Facility
$657.48
No comparable office rate is available.
Nebraska
Nebraska · 27422
Office
Unavailable
Facility
$632.67
No comparable office rate is available.
New Hampshire
New Hampshire · 27422
Office
Unavailable
Facility
$702.24
No comparable office rate is available.
Northern Nj
New Jersey · 27422
Office
Unavailable
Facility
$771.92
No comparable office rate is available.
Rest Of New Jersey
New Jersey · 27422
Office
Unavailable
Facility
$746.10
No comparable office rate is available.
New Mexico
New Mexico · 27422
Office
Unavailable
Facility
$688.07
No comparable office rate is available.
Nevada**
Nevada · 27422
Office
Unavailable
Facility
$687.44
No comparable office rate is available.
Nyc Suburbs/Long Island
New York · 27422
Office
Unavailable
Facility
$835.68
No comparable office rate is available.
Poughkpsie/N Nyc Suburbs
New York · 27422
Office
Unavailable
Facility
$756.50
No comparable office rate is available.
Queens
New York · 27422
Office
Unavailable
Facility
$804.77
No comparable office rate is available.
Rest Of New York
New York · 27422
Office
Unavailable
Facility
$663.27
No comparable office rate is available.
Ohio
Ohio · 27422
Office
Unavailable
Facility
$673.47
No comparable office rate is available.
Oklahoma
Oklahoma · 27422
Office
Unavailable
Facility
$651.48
No comparable office rate is available.
Portland
Oregon · 27422
Office
Unavailable
Facility
$719.24
No comparable office rate is available.
Rest Of Oregon
Oregon · 27422
Office
Unavailable
Facility
$676.93
No comparable office rate is available.
Metropolitan Philadelphia
Pennsylvania · 27422
Office
Unavailable
Facility
$730.31
No comparable office rate is available.
Rest Of Pennsylvania
Pennsylvania · 27422
Office
Unavailable
Facility
$670.58
No comparable office rate is available.
Puerto Rico
Puerto Rico · 27422
Office
Unavailable
Facility
$700.97
No comparable office rate is available.
Rhode Island
Rhode Island · 27422
Office
Unavailable
Facility
$707.36
No comparable office rate is available.
South Carolina
South Carolina · 27422
Office
Unavailable
Facility
$665.76
No comparable office rate is available.
South Dakota**
South Dakota · 27422
Office
Unavailable
Facility
$652.62
No comparable office rate is available.
Tennessee
Tennessee · 27422
Office
Unavailable
Facility
$639.56
No comparable office rate is available.
Austin
Texas · 27422
Office
Unavailable
Facility
$708.71
No comparable office rate is available.
Beaumont
Texas · 27422
Office
Unavailable
Facility
$667.09
No comparable office rate is available.
Brazoria
Texas · 27422
Office
Unavailable
Facility
$683.45
No comparable office rate is available.
Dallas
Texas · 27422
Office
Unavailable
Facility
$690.68
No comparable office rate is available.
Fort Worth
Texas · 27422
Office
Unavailable
Facility
$688.62
No comparable office rate is available.
Galveston
Texas · 27422
Office
Unavailable
Facility
$687.38
No comparable office rate is available.
Houston
Texas · 27422
Office
Unavailable
Facility
$725.45
No comparable office rate is available.
Rest Of Texas
Texas · 27422
Office
Unavailable
Facility
$676.86
No comparable office rate is available.
Utah
Utah · 27422
Office
Unavailable
Facility
$673.84
No comparable office rate is available.
Virginia
Virginia · 27422
Office
Unavailable
Facility
$673.27
No comparable office rate is available.
Virgin Islands
United States Virgin Islands · 27422
Office
Unavailable
Facility
$700.97
No comparable office rate is available.
Vermont
Vermont · 27422
Office
Unavailable
Facility
$661.46
No comparable office rate is available.
Rest Of Washington
Washington · 27422
Office
Unavailable
Facility
$702.20
No comparable office rate is available.
Seattle (King Cnty)
Washington · 27422
Office
Unavailable
Facility
$770.05
No comparable office rate is available.
Wisconsin
Wisconsin · 27422
Office
Unavailable
Facility
$638.20
No comparable office rate is available.
West Virginia
West Virginia · 27422
Office
Unavailable
Facility
$689.79
No comparable office rate is available.
See how rates vary across the country
27422 · 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?
Wyoming** is a Medicare payment area. Our Census mapping connects it to 205 cities and communities in Wyoming, 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 27422 in Wyoming**. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$748.75
$680.68 × 110% = $748.75
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 27422 in Wyoming**.
PPRRVU2026_Oct_nonQPP.csv
2,884
- Code
- 27422
- Physician work
- 9.95
- Practice expense
- 8.89
- Malpractice
- 2.08
GPCI2026.csv
112
- Locality
- Wyoming**
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.740
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 9.95 | × 1.000 | 9.9500 |
| Practice expense | 8.89 | × 1.000 | 8.8900 |
| Malpractice | 2.08 | × 0.740 | 1.5392 |
| Total RVUs | 20.3792 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Wyoming**$680.68
Open 27422 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 9.95 | 1 |
| Practice expense | 8.89 | 1 |
| Malpractice | 2.08 | 0.74 |
(9.95 × 1 + 8.89 × 1 + 2.08 × 0.74) × $33.4009 = $680.68
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
27422 · 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 | $680.68 | RVU26D |
| 2026-07-01 | Not available in this setting | $680.68 | RVU26C |
| 2026-04-01 | Not available in this setting | $680.68 | RVU26B |
| 2026-01-01 | Not available in this setting | $680.68 | RVU26A |
| 2025-10-01 | Not available in this setting | $720.43 | RVU25D |
| 2025-07-01 | Not available in this setting | $720.43 | RVU25C |
| 2025-04-01 | Not available in this setting | $720.43 | RVU25B |
| 2025-01-01 | Not available in this setting | $720.43 | RVU25A |
27422 billing questions
How does this differ from 27420?
Use 27422 when the reconstruction includes extensor-mechanism realignment, muscle advancement, or imbrication. Code 27420 is the related reconstruction without those added elements.
What should the operative report support?
Document patellar instability, the side treated, and the reconstruction performed, including any extensor realignment, muscle advancement, or imbrication.
How is bilateral surgery reported?
Report bilateral treatment with modifier 50. CMS lists bilateral payment at 150%.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be paid?
Assistant-at-surgery payment may be made. Co-surgeons are paid only with 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 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.
2,88127416,,Osteochondral knee autograft,A,,13.81,10.27,NA,10.27,,2.94,27.02,27.02,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,88227418,,Repair degenerated kneecap,A,,11.31,9.28,NA,9.28,,2.26,22.85,22.85,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,88327420,,Revision of unstable kneecap,A,,10.00,8.98,NA,8.98,,2.13,21.11,21.11,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,88427422,,Revision of unstable kneecap,A,,9.95,8.89,NA,8.89,,2.08,20.92,20.92,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,88527424,,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
10902402,WA,99,REST OF WASHINGTON,1.013,1.053,0.761
11011402,WV,16,WEST VIRGINIA,1.000,0.869,1.431
11106302,WI,00,WISCONSIN,1.000,0.958,0.308
11203602,WY,21,WYOMING**,1.000,1.000,0.740
113"MAC Assignments as of November 22, 2023",,,,,,
114,,,,,,
115*Work GPCI reflects a 1.5 floor in Alaska established by the MIPPA.,,,,,,