Soft tissue repair · Knee

27333

Open arthrotomy with removal of one or both semilunar cartilages (menisci) from the medial and/or lateral compartments of the knee joint.

Verified May 8, 2026 · 7 sources ↓

Medicare
$564.48
Total RVUs
16.9
Global, days
90
Region
Knee
Drawn from CMSAAPCFindacodeAnnexmed

Documentation requirements

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

Source · Editorial brief grounded in 7 cited references ↓

  • Specify the compartment(s) treated: medial, lateral, or both — do not use 'standard approach' language
  • Confirm open arthrotomy was performed, not arthroscopic access, to justify 27333 over 29880/29881
  • Document the clinical indication (meniscal tear pattern, degenerative change, failed conservative treatment) supporting medical necessity
  • Record the laterality — left or right knee — in both the operative note and the claim to support LT/RT modifiers
  • Note extent of cartilage removed and condition of remaining joint structures to support post-op clinical decisions and audit defense

Applicable modifiers

Modifiers commonly billed with this code.

Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual

22 Increased complexity 50 Bilateral procedure 51 Multiple procedures 52 Reduced services 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 LT Left side RT Right side XS Separate structure

What this code covers

Source · Editorial summary grounded in 7 cited references ↓

CPT 27333 covers an open meniscectomy — the surgeon incises the knee joint directly and excises the damaged semilunar cartilage (meniscus) from the medial compartment, lateral compartment, or both. This is the open surgical alternative to arthroscopic meniscectomy (29880–29881); the open approach is less common today but remains the correct code when no arthroscope is used. The procedure is typically indicated for torn or degenerated meniscal tissue that cannot be repaired or when arthroscopic access is insufficient.

The 90-day global period applies. All routine post-op office visits, dressings, and stitch removals through day 90 are bundled. Bill unrelated E&M services in the global window with modifier 24; a separately identifiable pre-op E&M on the day of surgery requires modifier 25. If a same-day procedure is distinct from 27333 (different site or service), append modifier 59 or XS and be prepared to justify medical necessity with documentation.

Site-of-service matters here: the HOPD and ASC facility payments differ substantially (see the Site of Service comparison table). Physician work RVU is the same regardless of setting, but your practice's effective reimbursement depends on whether the case is scheduled at an ASC versus hospital outpatient. Document the surgical approach and compartment(s) treated explicitly — medial, lateral, or both — since payers and auditors flag operative notes that omit this detail.

RVU & reimbursement

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

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU7.36
Practice expense RVU7.98
Malpractice RVU1.56
Total RVU16.9
Medicare national rate$564.48
Global period90 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

SettingMedicare rate (national)
Office (PFS non-facility)
Procedure performed in physician's office
$564.48
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 27333 get rejected.

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

  • Wrong code family selected: arthroscopic meniscectomy (29880/29881) billed as 27333 or vice versa when the operative note documents the actual approach
  • Missing or ambiguous laterality documentation leading to payer rejection without LT or RT modifier
  • Lack of medical necessity documentation — no imaging, conservative treatment history, or clear diagnosis linking to the procedure
  • Global period conflict: post-op E&M visit billed without modifier 24 when unrelated condition was treated within the 90-day window
  • Unbundling flags when chondroplasty or synovectomy is separately billed without meeting NCCI compartment-distinction requirements

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 7 cited references ↓

01What is the difference between 27333 and 29880/29881?
27333 is the open meniscectomy code — the surgeon makes a direct incision into the knee joint. Codes 29880 and 29881 are arthroscopic meniscectomies. Use 27333 only when no arthroscope was used. Billing 27333 when the operative note documents arthroscopic technique is a code-family mismatch and will trigger a denial or overpayment finding on audit.
02Does 27333 require a laterality modifier?
Yes. Append LT or RT on every claim. Most payers require laterality for knee procedures. Omitting it is a common cause of front-end rejection. If bilateral open meniscectomy is performed in the same session, use modifier 50 on a single line or separate LT/RT lines per payer instructions — verify your payer's preferred bilateral billing format before submitting.
03Can I bill chondroplasty (29877) separately with 27333?
Not routinely. NCCI bundles debridement/shaving of articular cartilage with meniscectomy codes. For Medicare patients, G0289 may be reportable if the chondroplasty was performed in a different compartment than the primary procedure. Same-compartment chondroplasty is not separately billable under any circumstance for Medicare.
04What E&M rules apply during the 90-day global period?
27333 carries a 90-day global period. Routine post-op visits are bundled. To bill an E&M during the global for an unrelated condition, append modifier 24. If a decision for surgery was made at a pre-op visit the day before or day of surgery, modifier 57 applies to that E&M. A separate, identifiable E&M on the day of surgery itself requires modifier 25.
05When is modifier 22 appropriate for 27333?
Use modifier 22 when the procedure was substantially more complex than typical — for example, severe adhesions, prior surgical scarring requiring extensive lysis, or unusual anatomy that materially increased physician work and time. The operative note must explicitly describe what made the case more complex and estimate the additional time or effort. Without that documentation, payers will strip modifier 22 and recoup the additional payment.
06Can 27333 and an arthroscopic knee code be billed together on the same knee the same day?
Generally no — 27333 is an open procedure and arthroscopic knee codes presuppose arthroscopic access. Billing both on the same knee the same day will trigger an NCCI edit and likely a medical review request. If a case genuinely converts from arthroscopic to open, document the conversion reason clearly and bill only the open code.

Sources & references

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

  1. 01CMS Physician Fee Schedule 2026
  2. 02
    cms.gov
    https://www.cms.gov/files/document/04-chapter4-ncci-medicare-policy-manual-2025finalcleanpdf.pdf
  3. 03
    aapc.com
    https://www.aapc.com/blog/51405-coding-knee-arthroscopy-with-precision/
  4. 04
    aapc.com
    https://www.aapc.com/codes/coding-newsletters/my-orthopedic-coding-alert/orthopedic-coding-navigate-unbundling-and-ncci-guidelines-in-arthroscopic-surgery-180252-article
  5. 05
    findacode.com
    https://www.findacode.com/cpt/27333-cpt-code.html
  6. 06
    aapc.com
    https://www.aapc.com/codes/cpt-codes/27333
  7. 07
    annexmed.com
    https://annexmed.com/knee-arthroscopy-cpt-codes

Mira AI Scribe

Mira's AI scribe captures the surgical approach (open arthrotomy vs. arthroscopic), compartment(s) treated (medial, lateral, or both), laterality, extent of meniscal tissue removed, and the intraoperative findings that drove excision over repair. That specificity prevents the most common audit flag for 27333 — an operative note that says 'knee cartilage removed' without naming the compartment or confirming open access, which opens the door to a code-family challenge or a medical necessity denial.

See how Mira captures CPT 27333 documentation

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