On this page

CMS RVU26D · Effective 2026-10-01

27486 Knee revision Medicare reimbursement rates in Washington

Reports revision of an existing total knee replacement when the surgeon revises one prosthetic component, such as for loosening, wear, or instability. Compare 27486 office and facility rates across CMS payment localities in Washington.

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 27486 in Washington?

Washington has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.

Office / nonfacility

No supported rate

Facility setting

$1272.55–$1383.02

2 of 2 localities have a supported rate.

Lowest: Rest Of Washington

Highest: Seattle (King Cnty)

A spread of $110.47 per service.

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.

Find 27486 in your payment locality →

Orthopedic surgery

About 27486: Single-component knee prosthesis revision

Reports revision of an existing total knee replacement when the surgeon revises one prosthetic component, such as for loosening, wear, or instability.

An orthopedic surgeon uses this code when revising one component of an existing total knee replacement, such as a femoral or tibial component. Typical reasons include component loosening, wear, or instability. The operation may include removing the old component and placing its replacement; the code also covers use of allograft. These revisions are generally performed in an operating room, usually in a hospital or ambulatory surgery setting.

Select this code when the operative report supports revision of one component, rather than revision of both components. Document the existing prosthesis, the component revised, the reason for revision, and the work performed. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed 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 27486

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 RVU20.59 · 54%
  • Practice expense (office) RVU13.23 · 35%
  • Malpractice RVU4.35 · 11%

16.3K

Medicare services in 2024 · #1226 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.

27486 compared with similar codes

Office rates for Washington, from the same CMS release.

27487

Knee revision

Both femoral and tibial components

No office rate

This code is for revision of one prosthetic component; 27487 is for revision of both components.

27447

Total knee replacement

Medial and lateral compartments

No office rate

Use 27447 for primary total knee replacement. This code is for revising one component of an existing total knee prosthesis.

27488

Knee prosthesis removal

Spacer may be inserted

No office rate

Use 27488 when the knee prosthesis is removed without replacement. This code describes revision and replacement of one component.

27446

Partial knee replacement

One compartment

No office rate

Code 27446 describes primary partial knee arthroplasty. This code applies to revision of one component in an existing total knee prosthesis.

Compare 27486 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.

2 of 2 payment localities

Office and facility base rates · shared scale starting at $0

Need rates for a whole code list?

Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.

Explore fee-sheet early access →

27486 billing questions

How do I distinguish this code from 27487?

Use this code when one prosthetic component is revised. Code 27487 describes revision of both components.

Can removal of the old component be billed separately?

Removal performed as part of replacing the component is part of the revision service. Code 27488 is for removal of a knee prosthesis without replacement.

Does allograft use change the code selection?

No. This code covers revision of one component with or without allograft; the component count remains the key distinction.

What documentation supports reporting this code?

The operative report should identify the existing knee prosthesis, the single component revised, the reason for revision, and the work performed.

How is bilateral reporting handled?

For a bilateral procedure reported with modifier 50, CMS pays 150% under the supplied fee schedule rule.

Can an assistant or co-surgeon be reported?

Assistant-at-surgery payment may be made. 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.

RVUs for 27486PPRRVU2026_Oct_nonQPP.csv, line 2,914 (RVU26D)