Billing code 27486: Knee revisionMedicare rate & RVUs in Florida

Reports revision of an existing total knee replacement when the surgeon revises one prosthetic component, such as for loosening, wear, or instability.

CMS RVU26DEffective Oct 1, 20263 payment localities16.3K Medicare services in 2024

CMS doesn’t publish an office rate for 27486 in Florida.

—Office (non-facility)
$1,328.55–$1,515.18Hospital or facility

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 27486 for the payment locality that covers the ZIP.

On this page 9 sections
  1. Rate in Florida
  2. What 27486 covers
  3. By payment locality
  4. How it’s calculated
  5. Payment rules
  6. Similar codes
  7. Related codes
  8. Billing questions
  9. Sources

What 27486 covers

An orthopedic surgeon uses this code when revising one component of an existing total knee replacement, such as a femoral or tibial component. Typical reasons include component loosening, wear, or instability. The operation may include removing the old component and placing its replacement; the code also covers use of allograft. These revisions are generally performed in an operating room, usually in a hospital or ambulatory surgery setting.

Select this code when the operative report supports revision of one component, rather than revision of both components. Document the existing prosthesis, the component revised, the reason for revision, and the work performed. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be available; 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 27486 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.

27486 office and facility rates by payment locality
Payment localityOfficeFacility
Fort LauderdaleUnavailable$1,398.05
MiamiUnavailable$1,515.18
Rest Of FloridaUnavailable$1,328.55

How the 27486 rate is calculated

Each of 27486’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 · 27486

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 20.59Practice expense 13.23Malpractice 4.35

38.1700 adjusted RVUs×$33.4009 conversion factor=$1,274.91

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 27486

27486 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 27486

Knee revision

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
Assistant at surgery (80/81/82/AS)2Paid.
Co-surgeons (62)1Permitted with supporting documentation.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.69/0.21Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 27486

Knee revision

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.

  • 24 Unrelated E/M visit by the same physician
  • 79 Unrelated procedure (starts its own global period)
  • 58 Staged, more extensive, or therapy procedure that was planned
  • 78 Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 50 · payment effect

With and without the modifier

27486 without 50 · national facility

$1,274.91

Knee revision

27486-50 · Bilateral: 150%

$1,912.37

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).

When to use modifier 50

27486 compared with similar codes

Compare codes

27486 vs 27487 vs 27447 vs 27488 vs 27446: national Medicare rates

Swap in your local Medicare rate.

  • 27486
    Knee revision · 20.59 wRVU
    —
  • 27487
    Knee revision · 26.43 wRVU
    —
  • 27447
    Total knee replacement · 19.11 wRVU
    —
  • 27488
    Knee prosthesis removal · 17.16 wRVU
    —
  • 27446
    Partial knee replacement · 16.7 wRVU
    —

How to choose

27487Knee revision
This code is for revision of one prosthetic component; 27487 is for revision of both components.
27447Total knee replacement
Use 27447 for primary total knee replacement. This code is for revising one component of an existing total knee prosthesis.
27488Knee prosthesis removal
Use 27488 when the knee prosthesis is removed without replacement. This code describes revision and replacement of one component.
27446Partial knee replacement
Code 27446 describes primary partial knee arthroplasty. This code applies to revision of one component in an existing total knee prosthesis.

27486 billing questions

How do I distinguish this code from 27487?

Use this code when one prosthetic component is revised. Code 27487 describes revision of both components.

Can removal of the old component be billed separately?

Removal performed as part of replacing the component is part of the revision service. Code 27488 is for removal of a knee prosthesis without replacement.

Does allograft use change the code selection?

No. This code covers revision of one component with or without allograft; the component count remains the key distinction.

What documentation supports reporting this code?

The operative report should identify the existing knee prosthesis, the single component revised, the reason for revision, and the work performed.

How is bilateral reporting handled?

For a bilateral procedure reported with modifier 50, CMS pays 150% under the supplied fee schedule rule.

Can an assistant or co-surgeon be reported?

Assistant-at-surgery payment may be made. Co-surgeon payment requires 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
RVUs for 27486PPRRVU2026_Oct_nonQPP.csv, line 2,914 (RVU26D)

Open CMS sourceHow we calculate rates

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