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CMS RVU26D · Effective 2026-10-01

27442 Knee revision Medicare reimbursement rates in Maine

Reports operative revision arthroplasty of the knee joint, generally performed by an orthopedic surgeon when the joint requires reconstructive surgical treatment. Compare 27442 office and facility rates across CMS payment localities in Maine.

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 27442 in Maine?

Maine has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.

Office / nonfacility

No supported rate

Facility setting

$747.61–$770.92

2 of 2 localities have a supported rate.

Lowest: Rest Of Maine

Highest: Southern Maine

A spread of $23.31 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.

Find 27442 in your payment locality →

Orthopedic surgery

About 27442: Knee joint arthroplasty revision

Reports operative revision arthroplasty of the knee joint, generally performed by an orthopedic surgeon when the joint requires reconstructive surgical treatment.

This code represents an operative revision arthroplasty involving the knee joint. An orthopedic surgeon typically performs the procedure in a hospital or ambulatory surgery facility, addressing a joint that needs reconstructive surgical treatment. The operative report should make clear what was revised and the work performed; a ligament reconstruction, patellar realignment, or routine primary total knee replacement is a different service.

Report the code when the documented operation supports this knee-joint revision service, rather than selecting it from the diagnosis alone. CMS assigns a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included. When multiple procedures occur 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%. An assistant at surgery may be paid; co-surgeons require supporting documentation, and team surgery is not permitted.

CMS billing rules for 27442

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 RVU12.06 · 50%
  • Practice expense (office) RVU9.51 · 39%
  • Malpractice RVU2.53 · 10%

114

Medicare services in 2024 · #4777 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.

27442 compared with similar codes

Office rates for Maine, from the same CMS release.

27443

Knee revision

Joint revision

No office rate

This related arthroplasty code includes debridement and partial synovectomy. Choose based on the operative service documented, not simply the diagnosis.

27446

Partial knee replacement

One compartment

No office rate

This code describes arthroplasty limited to the medial or lateral compartment. Use it when the operation meets that compartment-specific service rather than the revision service represented here.

27447

Total knee replacement

Medial and lateral compartments

No office rate

This code is for primary replacement of both knee compartments. It is not interchangeable with a revision procedure.

27486

Knee revision

One prosthetic component

No office rate

This code identifies revision total knee arthroplasty involving one component. Use it when the documented operation meets that component-specific revision service.

Compare 27442 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.

2 of 2 payment localities

Office and facility base rates · shared scale starting at $0

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27442 billing questions

How is this code different from a total knee replacement?

This code represents revision arthroplasty of the knee joint. A primary replacement of both knee compartments is reported with 27447 when the operative service meets that code’s criteria.

Does the 90-day global period include postoperative visits?

Yes. Related postoperative care for 90 days is included, along with the preoperative visit on the day before surgery.

How are other procedures performed in the same session paid?

The highest-valued procedure is paid in full; other procedures are subject to the standard multiple-procedure reduction, with payment at 50%.

Can modifier 50 be used for bilateral surgery?

CMS identifies this as a bilateral procedure; reporting with modifier 50 is paid at 150%.

Can an assistant or co-surgeon be reported?

An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation, and team surgery is not permitted.

What should the operative report establish?

Document the knee-joint revision performed and the operative work supporting this service. The diagnosis by itself does not establish which procedure code applies.

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.

RVUs for 27442PPRRVU2026_Oct_nonQPP.csv, line 2,896 (RVU26D)