Billing code 27443: Knee revisionMedicare rate & RVUs in Texas
Reports revision surgery on the knee joint, with the operative report identifying the revision work performed and the prior procedure or joint condition addressed.
CMS doesn’t publish an office rate for 27443 in Texas.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 27443 covers
This code represents revision surgery involving the knee joint. Orthopedic surgeons perform these operations in an operating room when prior knee surgery or joint treatment requires revision; the reason may include problems such as loosening, wear, or instability. The operative report should identify the prior work, the current joint findings, and the revision steps performed. The code should not be selected from the word “revision” alone: distinguish it from codes that specifically describe revision of a total knee replacement by the components revised.
Report the service for the documented knee joint revision, using the procedure details to distinguish it from primary knee arthroplasty and more specifically defined revision procedures. This major surgery has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. 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.
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.
Where 27443 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | Unavailable | $771.65 |
| Beaumont | Unavailable | $728.24 |
| Brazoria | Unavailable | $744.63 |
| Dallas | Unavailable | $752.73 |
| Fort Worth | Unavailable | $750.65 |
| Galveston | Unavailable | $749.05 |
| Houston | Unavailable | $792.43 |
| Rest Of Texas | Unavailable | $738.32 |
How the 27443 rate is calculated
Each of 27443’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 27443
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 11.12Practice expense 9.32Malpractice 2.37
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 27443
27443 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 27443
Knee revision
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.69/0.21 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 27443
Knee revision
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
27443 without 50 · national facility
$761.87
Knee revision
27443-50 · Bilateral: 150%
$1,142.81
Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).
27443 compared with similar codes
Compare codes
27443 vs 27486 vs 27487 vs 27447 vs 27446: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 27486Knee revision
- Use 27486 when the documented work revises one component of a total knee arthroplasty. This code is not defined by that one-component scope.
- 27487Knee revision
- Use 27487 when both components of a total knee arthroplasty are revised. Do not infer that scope unless the operative report supports it.
- 27447Total knee replacement
- Code 27447 describes primary total knee arthroplasty; this code is for revision surgery.
- 27446Partial knee replacement
- Code 27446 describes arthroplasty of a single knee compartment. This code represents revision work rather than that compartment-specific arthroplasty.
27443 billing questions
How is this code distinguished from 27486 or 27487?
Those codes specifically describe revision of a total knee arthroplasty based on whether one or both components are revised. Use this code only when the documented procedure matches its knee joint revision service rather than a more specifically defined total knee replacement revision.
Is this the code for a primary total knee replacement?
No. Code 27447 describes total knee arthroplasty; this code represents revision work. The operative report should support that the service is a revision rather than a primary replacement.
What documentation supports reporting this code?
Document the prior knee procedure or joint treatment, the current findings, and the specific revision work performed. Those details help distinguish this service from primary arthroplasty and revision codes defined by component count.
How does the 90-day global period affect postoperative billing?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period. The global period is tied to this major surgery.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeons are paid only when supporting documentation is submitted; team surgery is not permitted.
How are bilateral and same-session procedures handled?
Bilateral reporting with modifier 50 is paid at 150%. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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