CPT 27412: Knee Autologous Cartilage Transplantation

CPT code 27412 represents autologous cartilage transplantation to the knee, a surgical procedure that transplants a patient’s own cartilage to repair focal defects of the hyaline cartilage. This code matters nationally because cartilage restoration procedures address joint preservation, can reduce longer-term disability, and have implications for surgical utilization and specialty care capacity across health systems.

Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical context for the procedure, typical sites of service, and which payers commonly cover or adjudicate claims for this surgery. The publication outlines expected service settings, common procedural considerations, and the types of benchmarks and policy topics relevant to stakeholders, including coverage criteria, prior authorization practices, and utilization trends. It also highlights areas where data are commonly reported and notes where input data were not provided.

The report is intended for clinicians, billing professionals, payer policy staff, and health system administrators seeking a clear, national-level summary of coding, clinical intent, and payer landscape for cartilage transplantation to the knee under CPT code 27412.

Billing Code Overview

CPT code 27412 describes an autologous cartilage transplantation procedure in which the provider transplants cartilage from the patient’s own body into the knee to repair a defect of the hyaline cartilage. This procedure is a type of cartilage restoration surgery intended to treat focal chondral defects that may cause pain, dysfunction, or progressive joint deterioration.

Service type: Surgical cartilage transplantation / cartilage restoration procedure
Typical site of service: Hospital outpatient department or ambulatory surgical center, performed in an operating room setting

Clinical Context

A 28-year-old recreational athlete presents with persistent focal knee pain and mechanical symptoms after a prior traumatic cartilage injury of the femoral condyle that failed conservative care (physical therapy, activity modification, NSAIDs). MRI demonstrates a full-thickness focal chondral defect of the medial femoral condyle measuring approximately 2.0 cm² with otherwise preserved joint alignment and stable ligaments. The orthopedic sports surgeon determines the lesion is appropriate for an autologous osteochondral transplant (autograft mosaicplasty) to restore hyaline cartilage surface and relieve symptoms. The clinical workflow includes preoperative evaluation (history, physical exam, imaging, medical clearance), informed consent, intraoperative harvest of osteochondral plugs from a non-weightbearing zone of the ipsilateral knee, transplantation of plugs into prepared recipient sockets in the lesion, intraoperative check of graft stability, routine closure, and postoperative rehabilitation with protected weightbearing, range-of-motion protocols, and progressive strengthening. Typical site of service is an ambulatory surgical center or hospital outpatient department. The service type is an orthopedic surgical procedure (autologous osteochondral transfer) of the knee under general or regional anesthesia with possible same-day discharge or overnight observation depending on comorbidities and pain control.

Coding Specifications

Modifier	Description	When to Use
`LT`	Left side	Use when the procedure is performed on the left knee.

Taxonomy Code	Specialty	Notes
207L00000X	Orthopaedic Surgery	Primary specialty performing osteochondral autograft/transplant procedures.
208000000X	Physical Medicine & Rehabilitation	Manages postoperative rehabilitation protocols and nonoperative care pre/post surgery.
2086S0105X	Sports Medicine (Orthopaedic)	Subspecialty management for athletic patients requiring cartilage restoration.
207P00000X	Surgery - General	May be involved in perioperative care in some settings.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`M17.0`	Bilateral primary osteoarthritis of knee	May be an underlying degenerative condition contributing to focal cartilage defects considered for focal repair in select patients.
`M17.11`	Unilateral primary osteoarthritis, right knee	May coexist with focal chondral lesions that prompt cartilage restoration in younger patients with localized defects.
`M23.2`	Derangement of meniscus due to old tear or injury	Meniscal pathology often coexists and may be addressed at the time of cartilage restoration.
`S83.241A`	Bucket-handle tear of medial meniscus, current injury, right knee, initial encounter	Acute traumatic meniscal tears can accompany chondral defects requiring combined management.
`M94.2`	Chondromalacia patellae	Focal chondral damage of patellofemoral compartment that can be treated with targeted cartilage procedures.
`M22.2`	Recurrent dislocation of patella	Instability can produce focal cartilage lesions; addressing instability may be part of comprehensive care.
`S76.011A`	Contusion of right knee, initial encounter	Acute trauma to the knee leading to cartilage injury.
`M94.3`	Osteochondritis dissecans	Classic indication for osteochondral grafting when fragment or defect is symptomatic and focal.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`27412`	Osteochondral autograft(s) knee; including harvesting of autograft(s) and transplantation	This is the primary procedure code describing autologous osteochondral transplant of hyaline cartilage into the knee.
`29881`	Arthroscopy, knee, surgical; with meniscal transplantation (Note: example of arthroscopic cartilage-related surgery)	May be performed arthroscopically to assess joint, treat concurrent intra-articular pathology, or assist in graft site preparation.
`27370`	Arthrotomy, knee, debridement of articular cartilage and/or chondral defect	May be performed prior to grafting to prepare the recipient site and remove unstable cartilage.
`27690`	Excision or transplantation procedures about the knee (Note: general soft tissue procedures)	Can describe adjunctive procedures when addressing surrounding tissue or donor site management.
`20610`	Arthrocentesis, aspiration and/or injection; major joint or bursa (e.g., knee)	Used preoperatively or postoperatively for diagnostic aspiration or therapeutic injection if needed.

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Summary & Overview