Summary & Overview
CPT 27442: Arthroplasty of Femoral Condyles or Tibial Plateau
Headline: CPT 27442 — Partial Knee Arthroplasty Procedure for Focal Femoral or Tibial Articular Disease
Lead: CPT 27442 denotes arthroplasty of the femoral condyles or tibial plateau(s), a targeted knee procedure performed in inpatient hospital settings to address focal articular surface damage or degenerative disease. It is a clinically important option between conservative care and total knee arthroplasty.
What this code represents and why it matters: CPT 27442 captures surgical arthroplasty limited to the femoral condyles or tibial plateau(s), often used when disease is confined to part of the knee. Nationally, accurate use of this code influences procedure classification, inpatient utilization reporting, and appropriate surgical case mix distinctions versus total or revision knee arthroplasty.
Key payers covered: The publication addresses coverage and coding considerations for Aetna, Blue Cross Blue Shield, Cigna Health, Medicare, and UnitedHealthcare.
Overview of reader takeaways: Readers will get a concise clinical context for when CPT 27442 is used, how it relates to adjacent knee procedure codes, and typical inpatient site-of-service expectations. The content outlines coding nuances, common clinical indications, and payer coverage landscape to inform documentation and billing workflows. Data limitations: Service line metadata was not provided. Data not available in the input where indicated.
CPT Code Overview
CPT 27442 describes arthroplasty of the femoral condyles or tibial plateau(s) of the knee. This procedure involves surgical reconstruction or replacement of one or more articular surfaces of the knee joint to restore function and relieve pain associated with degenerative or traumatic joint conditions.
Service type: Orthopedic Surgery
Typical site of service: Inpatient Hospital (POS 21)
Clinical & Coding Specifications
Clinical Context
A 68-year-old patient with progressive knee pain, limited mobility, and radiographic evidence of degenerative joint disease presents for surgical management. Conservative treatments including physical therapy, activity modification, analgesics, and intra-articular injections have failed. The orthopedic surgeon evaluates the patient, documents severity of osteoarthritis and functional impairment, and schedules inpatient arthroplasty of the femoral condyles or tibial plateau(s) under general or regional anesthesia. Preoperative assessment, perioperative inpatient care, and postoperative rehabilitation are part of the clinical workflow for 27442.
Coding Specifications
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Modifiers:
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RT: Used when the procedure is performed on the right side. -
LT: Used when the procedure is performed on the left side. -
50: Used when the procedure is performed bilaterally in the same operative session. -
22: Used to report increased procedural services when the work, time, technical difficulty, or patient complexity is substantially greater than typically required. -
Provider Taxonomies: