No office rate
Use 27438 when the patellar arthroplasty includes a prosthetic implant. Use 27437 when the patellar arthroplasty is performed without one.
On this page
CMS RVU26D · Effective 2026-10-01
27438 Patellar arthroplasty Medicare reimbursement rates in Oregon
Reports surgical replacement or resurfacing of the patella with a prosthetic implant when the procedure is limited to the kneecap rather than a total knee replacement. Compare 27438 office and facility rates across CMS payment localities in Oregon.
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 27438 in Oregon?
Oregon 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
$756.55–$802.14
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 27438: Patellar arthroplasty with prosthetic implant
Reports surgical replacement or resurfacing of the patella with a prosthetic implant when the procedure is limited to the kneecap rather than a total knee replacement.
An orthopedic surgeon replaces or resurfaces the joint-facing surface of the patella with a prosthetic implant. The procedure addresses patellar joint damage when the operative plan is for patellar arthroplasty, rather than replacement of the full knee joint. It is performed in an operating room, typically in a hospital or ambulatory surgery center. The operative report should identify the patellar procedure and the use of a prosthetic component.
Report this code for the patellar arthroplasty itself; patellar resurfacing performed as part of a total knee arthroplasty is included in that broader procedure. The service has 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%. When performed bilaterally with modifier 50, payment is 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 27438
- 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 RVU11.59 · 50%
- Practice expense (office) RVU9.39 · 40%
- Malpractice RVU2.43 · 10%
1.5K
Medicare services in 2024 · #2669 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.
27438 compared with similar codes
Office rates for Oregon, from the same CMS release.
No office rate
Use 27447 for total knee arthroplasty. Do not separately report 27438 for patellar resurfacing performed as part of that replacement.
No office rate
This code is for patellar arthroplasty with a prosthetic implant. Code 27424 describes patellar removal rather than implant replacement.
Compare 27438 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
Portland →
Office / nonfacility
Unavailable
Facility
$802.14
Rest Of Oregon →
Office / nonfacility
Unavailable
Facility
$756.55
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27438 billing questions
How is this different from 27437?
This code includes a prosthetic implant for the patella. Code 27437 is the corresponding patellar arthroplasty without a prosthesis.
Can this be reported separately with total knee arthroplasty?
No. Patellar resurfacing performed as part of total knee arthroplasty is included in the broader procedure; do not separately report this code for that work.
What documentation supports reporting this code?
The operative report should describe the patellar arthroplasty and identify the prosthetic component. It should also make clear whether the service was a standalone patellar procedure or part of a broader knee replacement.
How does the 90-day global period affect postoperative care?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
How are bilateral procedures and multiple procedures in one session handled?
A bilateral procedure reported with modifier 50 is paid at 150%. For multiple procedures in the same session, the highest-valued procedure is paid in full and others at 50%.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be available. 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 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.
2,89027430,,Revision of thigh muscles,A,,9.91,8.92,NA,8.92,,2.10,20.93,20.93,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,89127435,,Incision of knee joint,A,,10.61,9.95,NA,9.95,,2.21,22.77,22.77,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,89227437,,Revise kneecap,A,,8.71,8.16,NA,8.16,,1.84,18.71,18.71,0,090,0.10,0.69,0.21,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,89327438,,Revise kneecap with implant,A,,11.59,9.39,NA,9.39,,2.43,23.41,23.41,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,89427440,,Revision of knee joint,A,,10.81,9.21,NA,9.21,,2.31,22.33,22.33,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,89527441,,Revision of knee joint,A,,11.25,9.36,NA,9.36,,2.40,23.01,23.01,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,89627442,,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