No office rate
Choose 27418 for tibial tubercle advancement intended to change patellofemoral loading. Code 27420 describes patellar reconstruction for dislocation.
On this page
CMS RVU26D · Effective 2026-10-01
27418 Tubercleplasty Medicare reimbursement rates in Kansas
Reports surgical advancement of the tibial tubercle to alter patellofemoral loading, typically for selected patients with persistent pain related to patellar mechanics. Compare 27418 office and facility rates across CMS payment localities in Kansas.
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 27418 in Kansas?
Kansas 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
$696.01
1 of 1 localities have a supported rate.
Payment area: Kansas
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 27418: Anterior tibial tubercle advancement
Reports surgical advancement of the tibial tubercle to alter patellofemoral loading, typically for selected patients with persistent pain related to patellar mechanics.
The surgeon cuts and repositions the tibial tubercle—the bony prominence below the kneecap where the patellar tendon attaches—to shift the patella’s loading pattern. This procedure is used in selected patients with persistent patellofemoral pain or abnormal patellar mechanics; it is not simply a repair of kneecap tissue. An orthopedic surgeon typically performs it in a surgical facility, with the patellar tendon remaining attached to the moved bone segment.
Report 27418 when the operative work includes this tibial tubercle advancement, rather than a procedure directed primarily at reconstructing patellar restraints or treating a cartilage defect. The record should identify the indication, side, relevant examination or imaging findings, and the osteotomy and repositioning performed. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. In a same-session multiple-procedure claim, the highest-valued procedure is paid in full and other procedures at 50%. 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.
CMS billing rules for 27418
- 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 RVU11.31 · 49%
- Practice expense (office) RVU9.28 · 41%
- Malpractice RVU2.26 · 10%
123
Medicare services in 2024 · #4714 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.
27418 compared with similar codes
Office rates for Kansas, from the same CMS release.
No office rate
Code 27422 is for patellar-dislocation reconstruction with extensor realignment or muscle advancement; 27418 is for repositioning the tibial tubercle.
No office rate
Code 27425 describes an open lateral retinacular release. It addresses lateral soft-tissue tightness rather than moving the tibial tubercle.
Compare 27418 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
Kansas →
Office / nonfacility
Unavailable
Facility
$696.01
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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 27418 in Kansas.
PPRRVU2026_Oct_nonQPP.csv
2,882
- Code
- 27418
- Physician work
- 11.31
- Practice expense
- 9.28
- Malpractice
- 2.26
GPCI2026.csv
54
- Locality
- Kansas
- Physician work
- 1.000
- Practice expense
- 0.904
- Malpractice
- 0.504
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 11.31 | × 1.000 | 11.3100 |
| Practice expense | 9.28 | × 0.904 | 8.3891 |
| Malpractice | 2.26 | × 0.504 | 1.1390 |
| Total RVUs | 20.8382 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Kansas$696.01
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 11.31 | 1 |
| Practice expense | 9.28 | 0.904 |
| Malpractice | 2.26 | 0.504 |
(11.31 × 1 + 9.28 × 0.904 + 2.26 × 0.504) × $33.4009 = $696.01
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.
27418 billing questions
How does 27418 differ from 27422?
27418 describes advancement of the tibial tubercle to change patellofemoral loading. Use 27422 when the operation is a patellar-dislocation reconstruction involving extensor realignment or muscle advancement.
What documentation supports 27418?
Document the patellofemoral indication, the operative side, relevant clinical or imaging findings, and the tibial tubercle osteotomy and repositioning performed.
Does the 90-day global include routine postoperative care?
Yes. The global period includes the day-before preoperative visit and 90 days of related postoperative care.
How is bilateral 27418 reported?
CMS lists this as a bilateral procedure; reporting modifier 50 is paid at 150%.
Can an assistant or co-surgeon be paid?
Assistant-at-surgery payment may be available. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
What happens when another procedure is performed in the same session?
Under the standard multiple-procedure rule, the highest-valued procedure is paid in full and the other procedures are paid 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.
2,87927412,,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
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
5106102,IL,99,REST OF ILLINOIS,1.000,0.913,1.563
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915
5607202,LA,01,NEW ORLEANS,1.000,0.941,1.136
5707202,LA,99,REST OF LOUISIANA,1.000,0.885,0.958