No office rate
Use 27446 when only one tibiofemoral compartment is replaced with a partial implant; use 27447 when both medial and lateral compartments are replaced.
On this page
CMS RVU26D · Effective 2026-10-01
27447 Total knee replacement Medicare reimbursement rates in Maine
Total knee replacement resurfaces the medial and lateral femoral condyles and tibial plateau, with optional patellar resurfacing, for advanced knee arthritis. Compare 27447 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 27447 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
$1077.65–$1106.32
2 of 2 localities have a supported rate.
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 27447: Primary total knee arthroplasty
Total knee replacement resurfaces the medial and lateral femoral condyles and tibial plateau, with optional patellar resurfacing, for advanced knee arthritis.
An orthopedic surgeon exposes the knee, removes damaged cartilage and bone from the distal femur and proximal tibia, balances the ligaments, and places femoral and tibial components with a polyethylene insert. The components may be cemented or press-fit, and the patella may also be resurfaced. Typical indications include advanced osteoarthritis, rheumatoid arthritis, and post-traumatic arthritis after conservative treatment has failed. Surgery is generally performed in a hospital or ambulatory surgery center.
Report one service per knee when both medial and lateral tibiofemoral compartments are replaced. The operative note should identify the compartments treated, implants placed, and whether the patella was resurfaced. Osteophyte removal, soft tissue balancing, and synovial work performed as part of the replacement are included. The 90-day global period includes the preoperative visit the day before surgery and related postoperative care. For bilateral same-session replacement, report modifier 50; Medicare pays 150%. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and additional procedures at 50%. An assistant at surgery may be paid; co-surgeons require supporting documentation. Team surgery is not permitted.
CMS billing rules for 27447
- 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 RVU19.11 · 55%
- Practice expense (office) RVU11.58 · 33%
- Malpractice RVU4.02 · 12%
571.6K
Medicare services in 2024 · #210 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.
27447 compared with similar codes
Office rates for Maine, from the same CMS release.
No office rate
27487 applies to revision of an existing total knee prosthesis involving the femoral and entire tibial components; 27447 describes replacement of the medial and lateral compartments rather than revision of a total knee prosthesis.
No office rate
27438 covers patellar arthroplasty with a prosthesis; when the patella is resurfaced as part of a total knee replacement, report 27447 for the replacement.
No office rate
27425 describes an open lateral release. A release performed for patellar tracking during total knee replacement is included in 27447.
Compare 27447 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
Rest Of Maine →
Office / nonfacility
Unavailable
Facility
$1077.65
Southern Maine →
Office / nonfacility
Unavailable
Facility
$1106.32
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27447 billing questions
Is patellar resurfacing billed separately with a total knee replacement?
No. The replacement includes patellar resurfacing when it is performed during the same operation.
Can an open lateral retinacular release be billed with this code?
A release performed for patellar tracking as part of the same knee replacement is included in the arthroplasty.
How are bilateral total knee replacements reported?
For both knees replaced in the same session, report one line with modifier 50 and one unit. Medicare pays 150% of the single-knee amount.
How is an assistant surgeon billed for this procedure?
An assistant at surgery may be paid. Physician assistants at surgery use modifier 80, 81, or 82 as appropriate; qualified nonphysician practitioners use modifier AS.
When may co-surgeons report this procedure?
Co-surgeons may be paid only when documentation supports the need for two surgeons performing distinct portions of the operation. Each surgeon reports the procedure with modifier 62.
Which visits are included in the global period?
The preoperative visit the day before surgery and related postoperative visits during the 90-day global period are included. An unrelated E/M service during that period may be reported with modifier 24 when supported.
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.
2,89627442,,Revision of knee joint,A,,12.06,9.51,NA,9.51,,2.53,24.10,24.10,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,89727443,,Revision of knee joint,A,,11.12,9.32,NA,9.32,,2.37,22.81,22.81,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,89827446,,Revision of knee joint,A,,16.70,11.13,NA,11.13,,3.53,31.36,31.36,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,89927447,,Total knee arthroplasty,A,,19.11,11.58,NA,11.58,,4.02,34.71,34.71,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,90027448,,Incision of thigh,A,,11.31,9.11,NA,9.11,,2.41,22.83,22.83,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,90127450,,Incision of thigh,A,,14.24,10.63,NA,10.63,,2.93,27.80,27.80,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,90227454,,Realignment of thigh bone,A,,18.69,12.70,NA,12.70,,3.98,35.37,35.37,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00