Billing code 27422: Patellar reconstructionMedicare rate & RVUs in Florida
Reports operative reconstruction for a dislocating kneecap when treatment includes extensor-mechanism realignment, muscle advancement, or imbrication.
CMS doesn’t publish an office rate for 27422 in Florida.
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 9 sections
What 27422 covers
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.
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 27422 pays more and less in Florida
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Fort Lauderdale | Unavailable | $758.74 |
| Miami | Unavailable | $817.15 |
| Rest Of Florida | Unavailable | $720.63 |
How the 27422 rate is calculated
Each of 27422’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 · 27422
RVUs × geographic indexes × conversion factor
Work9.95
9.95 RVUs× 1.000 GPCI
Practice expense8.89
8.89 RVUs× 1.000 GPCI
Malpractice2.08
2.08 RVUs× 1.000 GPCI
Adjusted RVUs
20.9200
Conversion factor
$33.4009
Medicare rate
$698.75
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 27422
27422 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 27422
Patellar reconstruction
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.69/0.21 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 27422
Patellar reconstruction
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.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
27422 without 50 · national facility
$698.75
Patellar reconstruction
27422-50 · Bilateral: 150%
$1,048.13
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).
27422 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 27420Patellar reconstruction
- 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.
- 27418Tubercleplasty
- This code concerns anterior tibial tubercle reconstruction. Code 27422 is for patellar-instability reconstruction with extensor realignment or muscle work.
- 27425Patellar release
- Code 27425 represents open lateral retinacular release. It is not the broader patellar-instability reconstruction with extensor realignment reported under 27422.
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 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
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