27420 Patellar reconstruction Medicare reimbursement rates in Rhode Island

An orthopedic surgeon uses this operation to stabilize a patella with recurrent dislocation or persistent instability. The work may involve soft-tissue or bony reconstruction around the kneecap, based on the patient’s anatomy and the cause of instability. It is typically performed in an operating room for a surgical episode rather than as an office service. The key distinction from 27422 is that this code is for reconstruction without the extensor-mechanism realignment specified by that code.

Select the code from the operative report’s description of the reconstruction and whether extensor realignment was performed. Documentation should identify the instability, the structures addressed, and the procedures used. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and others at 50%. Bilateral reporting with modifier 50 is paid at 150%. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.