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CPT 27446: Knee Compartment Reconstruction with Condyle and Plateau Repair
CPT code 27446 denotes surgical reconstruction of the medial or lateral compartment of the knee with reconstruction of the femoral condyles and tibial plateaus to relieve pain and improve gait. As a targeted compartmental knee arthroplasty/reconstruction, the code captures procedures intended to restore joint alignment and function in patients with localized joint disease or damage. This code matters nationally because knee arthroplasty and compartmental reconstructions are common drivers of surgical resource use, postoperative care pathways, and payer coverage policy decisions.
Key payers referenced include Aetna, Blue Cross Blue Shield, Cigna Health, United Healthcare, and Medicare. Readers will find an overview of clinical context for compartmental knee reconstruction, how CPT code 27446 compares to related knee arthroplasty codes, and the typical sites where the service is delivered. The publication also summarizes benchmarks used by major payers and Medicare for surgical categorization and coding, and highlights policy and billing considerations that affect authorization and claims processing for compartmental knee reconstructions.
The content is intended for providers, coding professionals, and policy analysts seeking a concise reference to CPT code 27446, its clinical purpose, payer coverage landscape, and where to locate relevant coding comparisons and administrative guidance.
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Billing Code Overview
CPT code 27446 describes a surgical reconstruction of a single compartment of the knee (medial or lateral) including reconstruction of the femoral condyle(s) and tibial plateau(s) to relieve pain and improve gait. This procedure is a compartmental knee arthroplasty/reconstruction aimed at restoring joint function in a diseased or damaged portion of the knee.
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Service type: Surgical procedure — knee compartment reconstruction/arthroplasty
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Typical site of service: Hospital operating room or ambulatory surgical center
National Reimbursement Benchmarks
Medicare’s mean rate of $1,063.30 sits well below BUCA’s average commercial level of $7,835.10, indicating a substantial gap between public reimbursement and this aggregated commercial benchmark. This divergence highlights that commercial arrangements as captured by BUCA are, on average, roughly seven times higher than Medicare for CPT 27446, which can affect perceived market value and payer mix economics.
Examining dispersion via the interquartile spread (P75–P25) shows Blue Cross Blue Shield has the widest spread at $15,498.20 (P75 $18,981.70 minus P25 $3,483.80), followed by BUCA at $9,363.00 (P75 $11,732.50 minus P25 $2,369.70). The tightest distributions are Aetna at $971.70 (P75 $1,197.70 minus P25 $222.80) and UnitedHealth Group at $1,263.50 (P75 $2,548.90 minus P25 $1,285.40), indicating relatively less variability in negotiated rates for those payers.