Summary & Overview
CPT 27487: Revision Arthroplasty of Knee, Femoral and Tibial Components
CPT code 27487 represents revision arthroplasty of the knee involving revision of both femoral and tibial components and possible use of allograft. Nationally, this code captures complex orthopedic reconstructive procedures performed when a previously implanted knee prosthesis requires removal and replacement due to mechanical failure, pain, infection, or wear. These procedures are resource-intensive, typically performed in hospital operating rooms with potential inpatient stays and significant postoperative care needs.
Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, United Healthcare, and Medicare. Readers will find an overview of clinical context for revision total knee arthroplasty, typical sites of service, common diagnostic reasons that lead to revision, and how this code relates to closely associated procedure codes. The publication provides benchmarks and reimbursement context where available, highlights coding relationships to related procedure codes, and summarizes expected billing considerations for this service line. The content is intended for clinical coders, reimbursement analysts, and health plan policy staff seeking a concise reference to CPT code 27487 and its role in national orthopedic surgical care.
Billing Code Overview
CPT code 27487 describes a revision arthroplasty of the knee in which the provider revises both the femoral and tibial components of a previously implanted knee prosthesis. The procedure involves removal of an existing artificial knee joint and placement of a new prosthesis; an allograft may or may not be used.
Service Type: Revision total knee arthroplasty (both femoral and tibial components revised).
Typical Site of Service: Inpatient or hospital-based operating room, where complex joint revision surgery and postoperative inpatient care are provided.
Clinical & Coding Specifications
Clinical Context
A 72-year-old patient with a prior right total knee arthroplasty presents with progressive knee pain, instability, and radiographic loosening of the femoral and tibial components. Conservative management has failed and preoperative assessment confirms component loosening and mechanical failure without acute infection. The surgical team plans a revision total knee arthroplasty to remove the existing prosthesis and implant new femoral and tibial components; intraoperative cultures are obtained to exclude infection and bone grafting/allograft may be used if there is bone loss. Typical workflow includes preoperative optimization and imaging, anesthesia evaluation, perioperative antibiotics, explantation of prior components, implantation of revision components (with or without allograft), intraoperative specimen collection if infection is suspected, postoperative pain control and physical therapy, and routine postop follow-up.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when the revision required substantially greater work or complexity than usual, documented in operative note. |
59 | Distinct procedural service | Use when a separate, unrelated procedure is performed at the same session and not typically bundled with the revision arthroplasty. |
62 | Two surgeons | Use when two surgeons work together as primary surgeons performing distinct portions of the revision. |
76 | Data not available in the input. | Data not available in the input. |
LT | Left side | Use to indicate procedure performed on the left knee when side-specific reporting is required. |
RT | Right side | Use to indicate procedure performed on the right knee when side-specific reporting is required. |
52 | Reduced services | Use when the procedure is partially reduced or not completed as planned. |
53 | Discontinued procedure | Use when the procedure is started but terminated due to extenuating circumstances. |
57 | Data not available in the input. | Data not available in the input. |
58 | Staged or related procedure or service by the same physician during the postoperative period | Use when a planned staged revision or a more extensive revision is planned and performed after the original procedure. |
79 | Unrelated procedure or service by the same physician during the postoperative period | Use when an unrelated procedure is performed during the global period. |
22 | Data repeated above. | Data repeated above. |
50 | Bilateral procedure | Use when both knees are revised in the same operative session (rare for revision TKA but applicable if performed). |
76 | Data not available in the input. | Data not available in the input. |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
207X00000X | Orthopaedic Surgery | General orthopaedic surgeons who perform joint reconstructions and revisions. |
207XX0004X | Adult Reconstructive Orthopaedic Surgery | Subspecialists focused on primary and revision joint arthroplasty including complex knee revisions. |
207XS0114X | Orthopaedic Surgery of the Spine | Data provided; not typically primary for knee arthroplasty but listed in input taxonomies. |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
T84.84XA | Pain due to internal orthopedic prosthetic devices, implants and grafts, initial encounter | Indicates postoperative pain related to the knee prosthesis prompting evaluation and potential revision. |
T84.83XA | Mechanical complication of internal joint prosthesis, initial encounter | Documents mechanical failure (loosening, instability, wear) of the knee prosthesis requiring revision surgery. |
M17.10 | Unilateral primary osteoarthritis, unspecified knee | Represents underlying degenerative joint disease that commonly leads to primary arthroplasty and potential later revision. |
M17.9 | Osteoarthritis of knee, unspecified | General osteoarthritis diagnosis related to the original indication for knee arthroplasty. |
Z96.651 | Presence of right artificial knee joint | History code documenting the presence of a right knee prosthesis; relevant to revision planning and laterality. |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
27486 | Revision of total knee arthroplasty, with or without allograft (other component) | Alternative revision code when only one component (femoral or tibial) is revised rather than both; used in the clinical workflow when component-specific revision is performed. |