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    OpenPayerBilling CodesRepair, Revision, and/or Reconstruction Procedures on the Femur (Thigh Region) and Knee JointCPT cpt-27446-knee-compartment-reconstruction-arthroplasty
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    CPT 27446: Knee Compartment Reconstruction, Condyle and Plateau

    Medicare pays $1063 and commercial payers pay $7835 on average nationally for this procedure.

    CPT code 27446 describes surgical reconstruction of the diseased or damaged medial or lateral compartment of the knee including reconstruction of the femoral condyle(s) and tibial plateau(s) to relieve pain and improve gait; service type: knee compartmental reconstruction/partial condylar and plateau reconstruction surgery; typical site of service: inpatient or outpatient hospital operating room or ambulatory surgical center.

    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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    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.

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    National Payer Mean Reimbursement Rates

    State Reimbursement Rates

    State: Alaska1 / 51

    Rate by payer

    Clinical & Coding Specifications

    Clinical Context

    A 62-year-old patient with a history of progressive, painful degenerative disease and local tumor involvement of the medial compartment of the knee presents with ambulatory dysfunction and axial deformity. Imaging demonstrates destruction of the medial femoral condyle and corresponding tibial plateau from a malignant neoplasm of the long bones of the right lower limb (C40.21), with pain refractory to conservative care. After multidisciplinary oncologic and orthopaedic evaluation, the patient is scheduled for compartmental knee reconstruction to resect diseased bone, reconstruct the affected femoral condyle and tibial plateau, and restore joint alignment and weight-bearing function.

    The clinical workflow includes preoperative oncologic staging and medical clearance, informed consent documenting oncologic indications and expected functional goals, intraoperative tumor resection and anatomic reconstruction of the medial (or lateral) compartment with appropriate fixation or prosthetic components, perioperative pathology confirmation as indicated, and postoperative rehabilitation with oncologic surveillance and routine orthopaedic follow-up. Typical perioperative services include anesthesia, intraoperative imaging as needed, and multidisciplinary coordination with medical oncology and physical therapy. Site of service is typically an inpatient hospital operating room; select cases may occur in hospital outpatient surgical centers if complexity and oncologic needs permit.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    27447

    Related Modifiers

    12 rows

    ModifierDescriptionWhen to Use
    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…
    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…
    51Modifier –51 (Multiple Procedures) is used when the same provider performs multiple procedures in the same session to identify secondary, non‑exempt procedures and indicate payment reduction logic…- Use modifier -51 when the same provider performs multiple distinct procedures during the same patient encounter: report the highest‑valued procedure first (no modifier) and append -51 to…
    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…
    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…
    59Modifier 59 indicates a distinct procedural service when two procedures that are not normally billed together are clinically and procedurally separate. The CPT definition (as reiterated by CMS)…- Use modifier -59 to report a distinct procedural service when documentation supports that the procedure reported is not normally billed together with another service on the same day because of a…
    26Modifier 26 (Professional Component) identifies and bills only the professional portion of a split service — the physician’s interpretation, report, and medical judgment — when the technical…- Use CPT Modifier -26 when you are billing only the professional component (PC) of a split‑bill eligible service—i.e., you performed the physician interpretation, medical judgment and prepared a…
    76Modifier -76, Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional, is appended when the same provider performs an identical, medically necessary procedure or…- Use modifier -76 when the same physician or other qualified health care professional performs an identical procedure or service a second (or subsequent) time on the same date of service and the…
    77Modifier 77 indicates that a previously performed procedure or service was legitimately repeated by a different physician or other qualified health care professional. The AMA’s CPT definition…- Use modifier 77 when a basic procedure or service already performed is repeated by a different physician or other qualified health care professional (for example, a second provider independently…

    Showing 1–10 of 12

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    207X00000X
    207XX0004X
    207XS0114X
    103K00000X
    208VP0014X
    173F00000X
    261QB0400X
    207WX0200X

    Related ICD-10-CM Codes

    6 rows

    ICD-10-CM CodeDescription
    C40.21Malignant neoplasm of long bones of right lower limb
    C40.22Malignant neoplasm of long bones of left lower limb
    C47.21Malignant neoplasm of peripheral nerves of right lower limb, including hip
    C47.22Malignant neoplasm of peripheral nerves of left lower limb, including hip
    C49.20Malignant neoplasm of connective and soft tissue of unspecified lower limb, including hip
    C49.21Malignant neoplasm of connective and soft tissue of right lower limb, including hip

    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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    Arthroplasty, knee, condyle and plateau; medial AND lateral compartments with or without patella resurfacing (total knee arthroplasty)
    Represents total knee arthroplasty involving both compartments; used when both medial and lateral compartments are reconstructed rather than a single-compartment reconstruction described by 27446.