No office rate
27405 is for primary repair of a knee collateral ligament. Use 27407 for primary repair of a cruciate ligament.
On this page
CMS RVU26D · Effective 2026-10-01
27407 Cruciate ligament repair Medicare reimbursement rates in Rhode Island
Reports primary surgical repair of a torn knee cruciate ligament when the surgeon repairs the native ligament rather than performing a graft reconstruction. Compare 27407 office and facility rates across CMS payment localities in Rhode Island.
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 27407 in Rhode Island?
Rhode Island 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
$757.33
1 of 1 localities have a supported rate.
Payment area: Rhode Island
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 27407: Primary cruciate ligament repair
Reports primary surgical repair of a torn knee cruciate ligament when the surgeon repairs the native ligament rather than performing a graft reconstruction.
This code represents primary surgical repair of a torn cruciate ligament in the knee, with augmentation or reinforcement included when performed. An orthopedic surgeon typically performs the operation in a hospital or ambulatory surgery center for a cruciate injury considered suitable for repair. The service is distinct from reconstruction that replaces or rebuilds ligament function with a graft, and from repair of a collateral ligament.
Select the code from the operative work, not the diagnosis alone. The report should identify the repaired cruciate ligament and describe the primary repair and any augmentation or reinforcement. Medicare assigns a 90-day global period: the day-before preoperative visit and related postoperative care during the following 90 days 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%. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 27407
- 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 RVU10.58 · 47%
- Practice expense (office) RVU9.57 · 43%
- Malpractice RVU2.25 · 10%
20
Medicare services in 2024 · #5911 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.
27407 compared with similar codes
Office rates for Rhode Island, from the same CMS release.
No office rate
27409 describes collateral ligament and/or capsule repair with local tissue. It is not the primary cruciate ligament repair represented by 27407.
No office rate
27428 represents intra-articular knee ligament reconstruction. Choose 27407 when the operative service is primary repair of the native torn cruciate ligament.
No office rate
29888 is the arthroscopically aided ACL repair or reconstruction code. Distinguish it from 27407 by the documented operative approach and whether the service is primary repair.
Compare 27407 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
Rhode Island →
Office / nonfacility
Unavailable
Facility
$757.33
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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 27407 in Rhode Island.
PPRRVU2026_Oct_nonQPP.csv
2,877
- Code
- 27407
- Physician work
- 10.58
- Practice expense
- 9.57
- Malpractice
- 2.25
GPCI2026.csv
92
- Locality
- Rhode Island
- Physician work
- 1.019
- Practice expense
- 1.033
- Malpractice
- 0.892
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 10.58 | × 1.019 | 10.7810 |
| Practice expense | 9.57 | × 1.033 | 9.8858 |
| Malpractice | 2.25 | × 0.892 | 2.0070 |
| Total RVUs | 22.6738 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Rhode Island$757.33
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 10.58 | 1.019 |
| Practice expense | 9.57 | 1.033 |
| Malpractice | 2.25 | 0.892 |
(10.58 × 1.019 + 9.57 × 1.033 + 2.25 × 0.892) × $33.4009 = $757.33
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.
27407 billing questions
How is 27407 different from a knee ligament reconstruction code?
Use 27407 for primary repair of the native torn cruciate ligament, including any augmentation or reinforcement. A reconstruction code represents a reconstruction rather than this primary repair.
Can 27407 be reported for a collateral ligament repair?
No. This code is for a cruciate ligament; 27405 describes primary collateral ligament repair, while 27409 addresses collateral ligament and/or capsule repair with local tissue.
Is 27407 appropriate when the cruciate procedure is arthroscopically aided?
Compare the operative approach and work with the arthroscopically aided cruciate procedure codes. For example, 29888 covers arthroscopically aided ACL repair or reconstruction; 27407 represents primary repair rather than graft reconstruction.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and related postoperative care during the 90 days after surgery.
How does Medicare handle another procedure performed in the same session?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple procedure reduction, with payment 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.
2,87427400,,Revise thigh muscles/tendons,A,,9.10,8.69,NA,8.69,,1.94,19.73,19.73,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,87527403,,Repair of knee cartilage,A,,8.40,8.12,NA,8.12,,1.76,18.28,18.28,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,87627405,,Repair of knee ligament,A,,8.85,8.43,NA,8.43,,1.80,19.08,19.08,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,87727407,,Repair of knee ligament,A,,10.58,9.57,NA,9.57,,2.25,22.40,22.40,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,87827409,,Repair of knee ligaments,A,,13.37,10.61,NA,10.61,,2.85,26.83,26.83,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,87927412,,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
8912502,PA,01,METROPOLITAN PHILADELPHIA,1.018,1.041,1.193
9012502,PA,99,REST OF PENNSYLVANIA,1.000,0.918,0.945
9109202,PR,20,PUERTO RICO,1.000,1.011,0.985
9214412,RI,01,RHODE ISLAND,1.019,1.033,0.892
9311202,SC,01,SOUTH CAROLINA,1.000,0.924,0.850
9403402,SD,02,SOUTH DAKOTA**,1.000,1.000,0.336
9510312,TN,35,TENNESSEE,1.000,0.909,0.537