CPT code 27403: Meniscus repair2026 Medicare rate & RVUs in Virginia
Report open surgical repair of a torn knee meniscus when the surgeon exposes the joint through an arthrotomy and repairs the tissue.
CMS doesn’t publish an office rate for 27403 in Virginia.
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 27403 covers
This code describes open repair of a torn meniscus, the crescent-shaped cartilage pad in the knee joint. An orthopedic surgeon exposes the joint through an arthrotomy and repairs the meniscal tissue, typically in an operating room. It is distinct from arthroscopic meniscus repair, which uses a scope and small portals rather than an open joint exposure.
Report the code when the operative record supports an open meniscal repair, including the tear treated and the repair performed. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For bilateral procedures reported with modifier 50, CMS pays at 150%. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and the others at 50%. 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 27403 pays more and less in Virginia
| Payment locality | Office | Facility |
|---|---|---|
| Dc + Md/Va Suburbs | Unavailable | $680.64 |
| Virginia | Unavailable | $588.67 |
How the 27403 rate is calculated
Each of 27403’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 · 27403
RVUs × geographic indexes × conversion factor
Work8.40
8.40 RVUs× 1.000 GPCI
Practice expense8.12
8.12 RVUs× 1.000 GPCI
Malpractice1.76
1.76 RVUs× 1.000 GPCI
Adjusted RVUs
18.2800
Conversion factor
$33.4009
Medicare rate
$610.57
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 27403
27403 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 27403
Meniscus repair
| 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 · 27403
Meniscus repair
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
27403 without 50 · national facility
$610.57
Meniscus repair
27403-50 · Bilateral: 150%
$915.86
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).
27403 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 29882Meniscus repair
- This code is for open meniscal repair. Code 29882 describes arthroscopic repair of one meniscus.
- 29883Meniscus repair
- This code is for open meniscal repair. Code 29883 describes arthroscopic repair of both menisci.
- 29881Knee meniscectomy
- Use this code for open repair of meniscal tissue; 29881 describes arthroscopic removal of meniscal tissue rather than repair.
- 27405Knee ligament repair
- This code repairs a knee meniscus. Code 27405 concerns repair of a knee ligament, a different structure.
27403 billing questions
When should this code be used instead of an arthroscopic meniscus repair code?
Use this code for an open meniscal repair performed through an arthrotomy. Arthroscopic repair is reported with 29882 for one meniscus or 29883 when both are repaired.
Can meniscectomy be reported instead when the meniscus is removed?
No. Meniscal resection rather than repair points to a meniscectomy code, such as 29881 for one meniscus or 29880 for both, when performed arthroscopically.
What documentation supports reporting open meniscus repair?
Document the affected knee, meniscus and tear, the open approach, and the repair performed. The operative report should distinguish repair from removal or arthroscopic treatment.
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.
How is bilateral repair handled under the CMS rules?
Report modifier 50 for a bilateral procedure; CMS pays the bilateral procedure at 150%.
May an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeons are paid only with 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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