Summary & Overview
CPT 27446: Partial Knee Arthroplasty, Medial or Lateral Compartment
CPT code 27446 is a nationally recognized billing code for partial knee arthroplasty, targeting either the medial or lateral compartment of the knee. This procedure is a critical option for patients with localized joint damage, offering an alternative to total knee replacement. The code is widely used in orthopedic surgery and is most commonly performed in hospital inpatient settings, reflecting the complexity and recovery needs associated with knee joint reconstruction.
Major payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, Medicare, and UnitedHealthcare. Understanding how these payers approach reimbursement and policy for CPT code 27446 is essential for providers, administrators, and policy analysts seeking to benchmark utilization, review clinical indications, and stay informed about evolving coverage criteria.
Readers will gain insights into the clinical context of partial knee arthroplasty, current billing practices, and relevant policy updates. The publication also highlights associated diagnoses, common modifiers, and related codes, providing a comprehensive overview for stakeholders in orthopedic surgery and medical billing. This summary serves as a resource for understanding national trends and payer perspectives on partial knee replacement procedures.
CPT Code Overview
CPT code 27446 describes an arthroplasty of the knee, specifically involving the condyle and plateau of either the medial or lateral compartment. This procedure is a form of orthopedic surgery typically performed to address joint damage or disease affecting one compartment of the knee. The most common site of service for this procedure is the hospital inpatient setting (Place of Service 21), where patients receive comprehensive care during their surgical stay. This code is used to identify and bill for partial knee replacement surgeries that focus on a single compartment, distinguishing it from total knee arthroplasty procedures.
Clinical & Coding Specifications
Clinical Context
A typical patient scenario involves an adult patient admitted to the hospital with a malignant neoplasm affecting the long bones, peripheral nerves, or connective and soft tissue of the lower limb, including the hip. The patient presents with pain, functional impairment, or structural compromise of the knee joint due to the tumor. The orthopedic surgeon evaluates the extent of disease and determines that a partial knee arthroplasty is indicated to restore joint function and alleviate symptoms. The procedure described by CPT code 27446 is performed, replacing the condyle and plateau of either the medial or lateral compartment of the knee. The clinical workflow includes preoperative imaging, surgical planning, intraoperative tumor resection as needed, and compartmental knee arthroplasty, followed by postoperative care and rehabilitation.
Coding Specifications
| Modifier Code | Description | Usage |
|---|---|---|
RT | Right side | Used when the procedure is performed on the right knee. |
LT | Left side | Used when the procedure is performed on the left knee. |