Billing code 27429: Knee reconstructionMedicare rate & RVUs in Utah
Reports open intra-articular plus extra-articular ligament reconstruction in one knee operation for instability requiring both forms of stabilization.
CMS doesn’t publish an office rate for 27429 in Utah.
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 27429 covers
This code describes reconstruction of knee ligament stabilizers using both an intra-articular and an extra-articular component. Orthopedic surgeons commonly perform the procedure for substantial knee instability when stabilization is needed inside and outside the joint, such as an intra-articular cruciate ligament reconstruction combined with extra-articular augmentation. It is generally performed in an operating room, often for complex ligament injuries or persistent instability.
Report the code when the operative documentation supports both components of the reconstruction; an isolated intra-articular or extra-articular reconstruction belongs to a different code in the family. The note should identify the reconstructed structures and describe the work performed in each location. CMS 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%. Modifier 50 bilateral reporting is paid at 150%. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation. 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.
27429 in Utah
| Payment locality | Office | Facility |
|---|---|---|
| Utah | Unavailable | $1,130.88 |
How the 27429 rate is calculated
Each of 27429’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 · 27429
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 17.10Practice expense 14.35Malpractice 3.64
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 27429
27429 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 27429
Knee reconstruction
| 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 · 27429
Knee reconstruction
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
27429 without 50 · national facility
$1,172.04
Knee reconstruction
27429-50 · Bilateral: 150%
$1,758.06
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).
27429 compared with similar codes
Compare codes
27429 vs 27427 vs 27428 vs 27407 vs 29888: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 27427Knee reconstruction
- Use 27427 for extra-articular ligament reconstruction alone. This code is for a combined operation with both intra-articular and extra-articular reconstruction.
- 27428Knee reconstruction
- Use 27428 for intra-articular ligament reconstruction alone. This code requires the additional extra-articular reconstruction component.
- 27407Cruciate ligament repair
- 27407 describes repair of a knee ligament. This code describes reconstruction involving both intra-articular and extra-articular stabilization.
- 29888ACL surgery
- 29888 describes arthroscopically aided ACL repair, augmentation, or reconstruction. This code is for combined intra-articular and extra-articular reconstruction, not an isolated arthroscopic ACL service.
27429 billing questions
When is this code selected instead of 27427 or 27428?
Use this code when the operation includes both intra-articular and extra-articular ligament reconstruction. Code 27427 describes extra-articular reconstruction, while 27428 describes intra-articular reconstruction.
Can this code be reported with an arthroscopic ACL reconstruction code?
The operative report should establish whether the service represents the combined intra- and extra-articular reconstruction described here or a separately reportable service. Do not separately report overlapping work merely because different techniques or incisions were used.
What documentation supports reporting the combined reconstruction?
Document the instability being treated, the ligament structures addressed, and the intra-articular and extra-articular reconstructive work performed. The record should make clear that both components were completed in the same operation.
Are routine postoperative visits separately reported?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How does CMS handle multiple procedures in the same session?
The highest-valued procedure is paid in full, and other procedures are paid at 50%. Modifier 50 bilateral reporting is paid at 150%.
May an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation, and 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 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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