Arthroscopy · Knee

Open arthrotomy of the knee with excision of the medial or lateral semilunar cartilage (meniscectomy) through a formal open incision.

Verified May 8, 2026 · 6 sources ↓

Medicare: $614.91
Total RVUs: 18.41
Global, days: 90
Region: Knee

Drawn from CMSCgsmedicareAAPCEmedny

Documentation requirements

What must appear in the operative or office note to support the claim.

Source · Editorial brief grounded in 6 cited references ↓

Specify laterality — medial OR lateral meniscus — explicitly in the operative note
Confirm open arthrotomy approach; distinguish from arthroscopic technique, which maps to different CPT codes
Document pre-operative imaging (MRI or X-ray) confirming meniscal pathology requiring excision
Record the extent of cartilage excised and any intraoperative findings that affect surgical decision-making
Include indication for open versus arthroscopic approach if arthroscopy would otherwise be expected
Note any concurrent procedures performed and justify separate billing with distinct anatomic or procedural basis

Applicable modifiers

Modifiers commonly billed with this code.

Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual

22 Increased complexity 24 Unrelated E/M during global 50 Bilateral procedure 51 Multiple procedures 52 Reduced services 58 Staged or related 59 Distinct service 62 Co-surgeons 76 Repeat, same physician 77 Repeat, another physician 78 Unplanned return — related 79 Unrelated during global 80 Assistant surgeon AS PA/NP/CNS assistant LT Left side RT Right side

What this code covers

Source · Editorial summary grounded in 6 cited references ↓

CPT 27332 covers an open meniscectomy of the knee — specifically, an arthrotomy with excision of either the medial or lateral semilunar cartilage. This is a distinct open surgical approach, not an arthroscopic procedure. The 90-day global period applies, covering the day-before visit, the surgery itself, and all routine postoperative care through day 90. Anything unrelated to the meniscectomy billed in that window requires modifier 24 (E/M) or modifier 79 (unplanned unrelated procedure).

This code is laterality-specific: use LT or RT to designate the operative knee. If both menisci are excised in the same open procedure, that work is captured under 27333 (medial AND lateral), not two units of 27332. Billing 27332 twice for the same encounter — or pairing it with 27333 — is a common bundling error. The site of service matters: HOPD and ASC payments differ substantially, and documentation must support the selected place of service.

RVU & reimbursement

Component RVUs and Medicare national rate. Actual payment varies by GPCI locality.

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU	8.25
Practice expense RVU	8.41
Malpractice RVU	1.75
Total RVU	18.41
Medicare national rate	$614.91
Global period	90 days

Payment by site of service

Medicare pays different rates by setting. HOPD typically pays substantially more than ASC for the same procedure.

Source · CMS OPPS Addendum B·ASC HCPCS payment rates·2026

Setting	Medicare rate (national)
Office (PFS non-facility) Procedure performed in physician's office	$614.91
HOPD (APC 5113) Hospital outpatient department	$3,342.87
ASC (PI A2) Ambulatory surgical center (freestanding)	$1,644.87

Common denial reasons

The recurring reasons claims for CPT 27332 get rejected.

Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓

Billing 27332 twice for bilateral procedure instead of using modifier 50 or switching to 27333 for medial AND lateral
Missing laterality modifier (LT/RT), triggering claim-level edits or requests for additional documentation
Bundling conflict when arthroscopic knee codes are billed on the same date without a modifier and documented distinct basis
Lack of supporting imaging or documented conservative treatment failure prior to surgical intervention
Global period violations — billing routine follow-up E/M within the 90-day window without modifier 24

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 6 cited references ↓

01What's the difference between 27332 and 27333?

27332 covers excision of the medial OR lateral meniscus through an open arthrotomy. 27333 is used when both the medial AND lateral menisci are excised at the same operative session. Don't bill 27332 twice for bilateral work — use 27333, or 27332 with modifier 50 if the intent is truly separate unilateral procedures on opposite knees, which is uncommon.

02Can 27332 be billed on the same day as an arthroscopic knee code?

Only with strong documentation and an appropriate modifier. Open and arthroscopic procedures on the same knee the same day are unusual and will attract scrutiny. NCCI PTP edits may apply depending on the specific arthroscopic code paired. Use modifier 59 or an X modifier only when the procedures are genuinely distinct and separately documented.

03Is 27332 performed arthroscopically or open?

Open only. This code requires an arthrotomy — a formal open incision into the knee joint. Arthroscopic meniscectomy maps to 29880 (medial AND lateral) or 29881 (medial OR lateral). Using 27332 for an arthroscopic case is a miscoding error.

04Which laterality modifier is required?

Use LT for left knee and RT for right knee. Most payers require one of these on any unilateral knee procedure. Missing laterality is a clean-claim failure point and often delays or denies payment.

05What global period applies, and what does it include?

27332 carries a 90-day global. It includes the day-before preoperative visit, the surgery, and all routine post-op care through day 90. E/M visits for unrelated conditions in the global window need modifier 24. A staged or unrelated procedure in the global needs modifier 79.

06When is modifier 22 appropriate for 27332?

Use modifier 22 when the work substantially exceeds the typical effort for a standard open meniscectomy — for example, severe adhesions, prior failed surgery creating abnormal anatomy, or unusual complexity requiring significantly more operative time. The operative note must explicitly document why the case was more demanding than usual, and you should attach a cover letter when submitting.

Sources & references

Editorial content was developed using the following public sources. Last verified May 8, 2026.

Mira AI Scribe

Mira's AI scribe captures the operative approach (open arthrotomy), the specific meniscal compartment excised (medial or lateral), laterality, and the clinical indication driving the decision for open rather than arthroscopic technique. It flags when operative dictation doesn't explicitly state medial vs. lateral — the single most common reason 27332 claims pend for additional documentation before processing.

See how Mira captures CPT 27332 documentation