No office rate
Both describe open osteochondral grafting of the knee. Choose 27416 for tissue harvested from the patient; 27415 uses donor tissue.
On this page
CMS RVU26D · Effective 2026-10-01
27416 Knee cartilage graft Medicare reimbursement rates in Colorado
Open transfer of a patient’s own osteochondral tissue treats a focal knee defect when healthy cartilage and underlying bone are grafted into the affected area. Compare 27416 office and facility rates across CMS payment localities in Colorado.
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 27416 in Colorado?
Colorado has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$908.48
1 of 1 localities have a supported rate.
Payment area: Colorado
One mapped payment locality.
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.
Orthopedic surgery
About 27416: Open knee osteochondral autograft
Open transfer of a patient’s own osteochondral tissue treats a focal knee defect when healthy cartilage and underlying bone are grafted into the affected area.
The surgeon harvests one or more plugs of cartilage and underlying bone from a less weight-bearing area of the patient’s knee and transfers them to a focal defect in the same knee. Orthopedic surgeons use this approach for selected cartilage and osteochondral injuries, including defects associated with osteochondritis dissecans. The service is performed through an open approach, commonly in a hospital or ambulatory surgery setting.
Report the code when the operative record supports open autologous osteochondral grafting, including the defect’s location and the harvest and recipient sites. Distinguish it from grafting with donor tissue or from cartilage-cell implantation. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For same-session procedures, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.
CMS billing rules for 27416
- 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 is paid only with documentation of medical necessity.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU13.81 · 51%
- Practice expense (office) RVU10.27 · 38%
- Malpractice RVU2.94 · 11%
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.
27416 compared with similar codes
Office rates for Colorado, from the same CMS release.
No office rate
27412 involves an autologous chondrocyte implant. This code describes transferring the patient’s own osteochondral plugs, including underlying bone.
No office rate
Both involve knee osteochondral autografting, but 29866 is the arthroscopic procedure; 27416 is the open procedure.
Compare 27416 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.
1 of 1 payment localities
Colorado →
Office / nonfacility
Unavailable
Facility
$908.48
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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 27416 in Colorado.
PPRRVU2026_Oct_nonQPP.csv
2,881
- Code
- 27416
- Physician work
- 13.81
- Practice expense
- 10.27
- Malpractice
- 2.94
GPCI2026.csv
37
- Locality
- Colorado
- Physician work
- 1.012
- Practice expense
- 1.064
- Malpractice
- 0.781
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 13.81 | × 1.012 | 13.9757 |
| Practice expense | 10.27 | × 1.064 | 10.9273 |
| Malpractice | 2.94 | × 0.781 | 2.2961 |
| Total RVUs | 27.1991 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Colorado$908.48
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 13.81 | 1.012 |
| Practice expense | 10.27 | 1.064 |
| Malpractice | 2.94 | 0.781 |
(13.81 × 1.012 + 10.27 × 1.064 + 2.94 × 0.781) × $33.4009 = $908.48
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.
27416 billing questions
How does this differ from 27415?
This code is for osteochondral tissue harvested from the same patient. Code 27415 is the open procedure using donor osteochondral tissue.
How does this differ from 27412?
This code transfers osteochondral plugs, including bone, from the patient’s own knee. Code 27412 describes knee treatment using an autologous chondrocyte implant rather than transferred osteochondral plugs.
When is 29866 more appropriate?
Code 29866 describes arthroscopic osteochondral autografting. Use 27416 for the open approach when the documented procedure meets its service description.
What operative details support reporting?
Document the focal defect and its knee location, the open grafting technique, and the autologous harvest and recipient sites. Include laterality.
How is bilateral treatment reported?
For bilateral procedures, modifier 50 is paid at 150% under the CMS facts provided. The 90-day global period applies to the surgery.
Can an assistant surgeon be reported?
Assistant-at-surgery payment is allowed only when medical necessity is documented. Co-surgeons and team surgery are 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.
2,87827409,,Repair of knee ligaments,A,,13.37,10.61,NA,10.61,,2.85,26.83,26.83,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,87927412,,Autochondrocyte implant knee,A,,24.12,15.50,NA,15.50,,5.13,44.75,44.75,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,88027415,,Osteochondral knee allograft,A,,19.50,14.03,NA,14.03,,4.15,37.68,37.68,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,88127416,,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
3401112,CA,69,VISALIA,1.017,1.096,0.536
3501112,CA,70,YUBA CITY,1.017,1.096,0.536
3601112,CA,75,REST OF CALIFORNIA,1.017,1.096,0.536
3704112,CO,01,COLORADO,1.012,1.064,0.781
3813102,CT,00,CONNECTICUT,1.020,1.077,1.210
3912202,DC,01,DC + MD/VA SUBURBS,1.054,1.178,1.113
4012102,DE,01,DELAWARE,1.005,0.988,0.899