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    OpenPayerBilling CodesRepair, Revision, and/or Reconstruction Procedures on the Femur (Thigh Region) and Knee JointCPT cpt-27443-knee-femoral-condyle-tibial-plateau-reconstruction-synovectomy
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    CPT 27443: Knee Femoral Condyle/Tibial Plateau Reconstruction with Partial Synovectomy

    Medicare pays $776 on average nationally for this procedure.

    CPT code 27443 describes surgical reconstruction of defects in the femoral condyles or tibial plateaus combined with a partial synovectomy and knee debridement to relieve pain and improve gait; this is an open knee reconstruction and debridement procedure typically performed in the operating room as an inpatient or outpatient surgical service for patients with focal articular surface defects and symptomatic synovitis.

    For related coverage guidance, see recent payer policy updates: Implants for Joint Pain, Orthopedic Applications of Stem Cell Therapy, Bone Lengthening (Distraction Osteogenesis).

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    Table of contents

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    Clinical & Coding Specifications

    Clinical Context

    A 62-year-old ambulatory patient with progressive medial compartment osteoarthritic degeneration presents with increasing knee pain, mechanical catching, and an antalgic gait limiting activities of daily living. Conservative measures including physical therapy, NSAIDs, intra-articular corticosteroid injections, and bracing have failed to provide durable relief. Preoperative evaluation includes weight-bearing radiographs demonstrating focal femoral condyle and tibial plateau articular surface defects, routine labs, medical clearance, and informed consent for joint preservation surgery.

    In the operating room under regional or general anesthesia, the orthopedic surgeon performs diagnostic arthroscopy for intra-articular assessment, then proceeds to open or arthroscopically-assisted reconstruction of the femoral condyle and/or tibial plateau defects. The procedure includes debridement of nonviable cartilage, contouring and grafting or resurfacing of focal defects, and a partial synovectomy to remove inflamed synovial tissue. Hemostasis and irrigation are achieved, and the incision is closed. Postoperative care includes pain control, thromboprophylaxis as indicated, early range-of-motion exercises, and a plan for progressive weight-bearing with physical therapy to improve gait and function.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    29881Arthroscopy, knee, surgical; with meniscal repair (medial OR lateral)Diagnostic arthroscopy and treatment of concurrent meniscal pathology may be performed before or during reconstruction.
    29877Arthroscopy, knee, surgical; debridement/shaving of articular cartilage (chondroplasty)Frequently performed arthroscopically to contour cartilage and prepare defect margins prior to reconstruction.
    27447Reconstruction, knee collateral ligament, repair or augmentation, when performedPerformed if significant ligamentous instability is identified and needs correction in the same operative setting.
    27446Osteotomy, femoral or tibial, when performed with knee joint proceduresMay be indicated when malalignment contributes to focal condylar or plateau defects and is addressed to optimize repair durability.
    20610Arthrocentesis, aspiration and/or injection, major joint or bursa (e.g., knee)Used preoperatively or postoperatively for diagnostic aspiration, therapeutic injections, or viscosupplementation.
    20680Removal of implant; deep (e.g., for prior hardware causing articular damage)Performed if prior hardware removal is required to access or reconstruct defects within the knee.

    Related Modifiers

    11 rows

    ModifierDescriptionWhen to Use
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    66Modifier 66 (Surgical Team) is used when three or more surgeons act as primary surgeons on a single, highly complex procedure. The AMA defines it for use when a surgical team — often composed of…- Use modifier 66 when three or more surgeons act as primary surgeons working collaboratively as a surgical team on a single, highly complex or difficult procedure (for example organ…
    80CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…
    81Modifier -81 indicates a physician served as a minimal assistant surgeon for part—not all—of an operative procedure. Use when a physician’s assisting role is limited and does not represent full…- Use CPT modifier -81 when a physician acts as a minimum assistant surgeon who assists during only part (a limited portion) of an operative procedure; append -81 to the primary surgical CPT code to…
    82Modifier 82 is appended to a surgical CPT code to indicate that an attending physician acted as an assistant because a qualified resident surgeon was unavailable. In teaching hospitals it documents…- When to use: Append modifier 82 in teaching-hospital settings to indicate a physician served as an assistant surgeon because a qualified resident surgeon was unavailable (includes situations where…
    50Modifier –50 (Bilateral Procedure) is appended to a CPT code when an identical procedure is performed on paired anatomical structures during the same operative session. The AMA states to add…- Use modifier -50 when the same CPT surgical, diagnostic, or radiology procedure is performed on paired anatomical structures (both sides of the body) during the same operative/session by the same…
    23Modifier -23 (Unusual Anesthesia) is used on anesthesia service CPT codes when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia…- Use modifier -23 only on anesthesia CPT codes (00100–01999) when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia because of…

    Showing 1–10 of 11

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    207X00000X
    207L00000X
    2086S0122X
    2080S0010X
    207K00000X
    261QM1101X
    163WD1100X
    2085B0100X

    Related Payer Policy Updates

    Specialty: Orthopedics/Musculoskeletal1 / 3

    10 rows

    PolicyPayerEffective Date
    Implants for Joint PainBlue Cross Blue Shield - Rhode Island2027-03-01
    Orthopedic Applications of Stem Cell TherapyBlue Cross Blue Shield - Rhode Island2027-01-01
    Bone Lengthening (Distraction Osteogenesis)Blue Cross Blue Shield - North Dakota2027-01-01
    Orthopedic Joint Procedures of the Knee for Managed Medicaid (MMC), Health and Recovery Plan (HARP), Child Health Plus (CHP), and Essential Plan (EP) Membersuniverahealthcare2027-01-01
    Sacroiliac Joint Fusion for the Treatment of Adult Low-Back Pain Medical PolicyHealth-New-England2026-12-01
    Bone Grafts and Stabilization Devices for Spinal Defects - Medical PolicyHealth-New-England2026-12-01
    Implantable Shock Absorbers for Treatment of Knee Osteoarthritisblue cross blue shield - louisiana2026-12-01
    Autologous Chondrocyte Transplantation or Implantation Corporate Medical Policybcbsvermont2026-12-01
    Cartilage Implants for Joint Painpremerabluecrossofwashington2026-11-06
    Cartilage Implants for Joint Painpremerabluecrossofwashington2026-11-06

    Related Codes

    CPT-27380-INFRAPATELLAR-TENDON-PRIMARY-REPAIR

    CPT 27380: Primary Repair of Infrapatellar (Patellar) Tendon

    CPT-27381-SECONDARY-INFRAPATELLAR-TENDON-REPAIR

    CPT 27381: Secondary Repair of Infrapatellar Tendon

    CPT-27385-HAMSTRING-QUADRICEPS-RUPTURE-REPAIR-SUTURE

    CPT 27385: Primary Repair of Hamstring or Quadriceps Rupture

    CPT-27386-SECONDARY-QUADRICEPS-HAMSTRING-REPAIR-AUTOGRAFT

    CPT 27386: Secondary Repair of Quadriceps or Hamstring with Graft

    CPT-27390-OPEN-TENOTOMY-HAMSTRING-SINGLE-TENDON

    CPT 27390: Open Tenotomy of Hamstring Tendon

    CPT-27391-OPEN-HAMSTRING-TENOTOMY

    CPT 27391: Open Tenotomy of Multiple Hamstring Tendons

    CPT-27392-OPEN-TENOTOMY-HAMSTRING-BILATERAL

    CPT 27392: Open Bilateral Hamstring Tenotomy

    CPT-27393-HAMSTRING-TENDON-LENGTHENING

    CPT 27393: Hamstring Tendon Lengthening

    CPT-27394-HAMSTRING-TENDON-LENGTHENING-UNILATERAL

    CPT 27394: Hamstring Tendon Lengthening, Unilateral

    CPT-27395-HAMSTRING-TENDON-LENGTHENING-BILATERAL

    CPT 27395: Bilateral Hamstring Tendon Lengthening

    Showing 1–10 of 59

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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