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 Knee reconstruction Medicare reimbursement rates in California
Report this procedure for surgical reconstruction of an intra-articular knee ligament, commonly a cruciate ligament, when reconstruction rather than direct repair is performed. Compare 27428 office and facility rates across CMS payment localities in California.
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 27428 in California?
California has 29 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 29 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$1039.82–$1234.12
29 of 29 localities have a supported rate.
Lowest: Chico
Highest: San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
A spread of $194.30 per service.
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 27428 pays more and less in California
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 California, 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.
Compare 27428 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.
29 of 29 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Bakersfield | Office Unavailable | Facility $1048.71 |
| Chico | Office Unavailable | Facility $1039.82 |
| El Centro | Office Unavailable | Facility $1040.36 |
| Fresno | Office Unavailable | Facility $1039.82 |
| Hanford-Corcoran | Office Unavailable | Facility $1039.82 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Office Unavailable | Facility $1102.80 |
| Madera | Office Unavailable | Facility $1039.82 |
| Merced | Office Unavailable | Facility $1039.82 |
| Modesto | Office Unavailable | Facility $1039.82 |
| Napa | Office Unavailable | Facility $1154.53 |
| Oxnard-Thousand Oaks-Ventura | Office Unavailable | Facility $1091.36 |
| Redding | Office Unavailable | Facility $1039.82 |
| Rest Of California | Office Unavailable | Facility $1039.82 |
| Riverside-San Bernardino-Ontario | Office Unavailable | Facility $1074.53 |
| Sacramento-Roseville-Folsom | Office Unavailable | Facility $1077.95 |
| Salinas | Office Unavailable | Facility $1073.71 |
| San Diego-Chula Vista-Carlsbad | Office Unavailable | Facility $1089.59 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Office Unavailable | Facility $1204.60 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Office Unavailable | Facility $1200.93 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Office Unavailable | Facility $1234.12 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Office Unavailable | Facility $1219.13 |
| San Luis Obispo-Paso Robles | Office Unavailable | Facility $1058.11 |
| Santa Cruz-Watsonville | Office Unavailable | Facility $1092.45 |
| Santa Maria-Santa Barbara | Office Unavailable | Facility $1075.17 |
| Santa Rosa-Petaluma | Office Unavailable | Facility $1102.54 |
| Stockton | Office Unavailable | Facility $1039.82 |
| Vallejo | Office Unavailable | Facility $1149.25 |
| Visalia | Office Unavailable | Facility $1039.82 |
| Yuba City | Office Unavailable | Facility $1039.82 |
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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