Surgical removal of the patella (kneecap), either in full (patellectomy) or in part (hemipatellectomy), performed as an open procedure on the knee.

Verified May 8, 2026 · 6 sources ↓

Medicare: $620.25
Total RVUs: 18.57
Global, days: 90
Region: Knee

Drawn from CMSAbosMdclarityAAPC

Documentation requirements

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

Source · Editorial brief grounded in 6 cited references ↓

Specify whether full patellectomy or hemipatellectomy (extent of resection) was performed
Document the clinical indication with supporting imaging or prior treatment history
Describe the surgical approach and technique for extensor mechanism reconstruction
Include intraoperative findings that confirm the patella was excised, not merely debrided or resurfaced
Note anesthesia type (general or regional) and laterality of the operative knee
Document any concurrent procedures performed at the same session and their anatomic sites

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 58 Staged or related 59 Distinct service 78 Unplanned return — related 79 Unrelated during global LT Left side RT Right side

What this code covers

Source · Editorial summary grounded in 6 cited references ↓

CPT 27350 covers open patellectomy or hemipatellectomy — complete or partial surgical excision of the kneecap. Indications include severely comminuted patellar fractures not amenable to fixation, advanced patellofemoral arthritis, chronic patellar tendinopathy refractory to conservative care, osteomyelitis, or patellar tumors. The surgeon incises over the anterior knee, separates the extensor mechanism tissues, excises the patella fully or partially, then reconstructs the quadriceps and patellar tendon attachments to preserve extensor function before closing.

This is a 090-day global procedure. All routine post-op visits, dressing changes, and suture removal through day 90 are bundled. Any E/M service on the same day as surgery for a separate, unrelated condition needs modifier 25. A separate procedure performed during the global period by the same surgeon requires modifier 78 (related, unplanned return to OR) or 79 (unrelated procedure).

Distinguish full patellectomy from hemipatellectomy in the operative note — both fall under 27350, but documentation must specify extent of resection to survive audit. Do not confuse this code with patellar bone spur removal alone (which does not involve partial or complete patellar excision) or with patellar component exchange in a prior TKA, which requires revision arthroplasty coding.

RVU & reimbursement

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

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU	8.44
Practice expense RVU	8.37
Malpractice RVU	1.76
Total RVU	18.57
Medicare national rate	$620.25
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	$620.25
HOPD (APC 5114) Hospital outpatient department	$7,413.38
ASC (PI A2) Ambulatory surgical center (freestanding)	$3,695.53

Common denial reasons

The recurring reasons claims for CPT 27350 get rejected.

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

Operative note fails to distinguish patellectomy from patellar debridement or bone spur removal, triggering down-coding or denial
Missing or insufficient documentation of medical necessity — no imaging, failed conservative treatment, or diagnostic workup noted
Bilateral modifier 50 submitted without documentation that both knees were operated on in the same session
Same-day E/M billed without modifier 25, bundled into the surgical package by payer
Modifier 78 and 79 confused on return-to-OR claims during the 90-day global period

Frequently asked questions

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

01Does 27350 cover both complete and partial kneecap removal?

Yes. The same code covers full patellectomy and hemipatellectomy. Document the extent of resection clearly — complete vs. partial — in the operative note.

02Can 27350 be billed with other knee procedures on the same day?

Yes, with modifier 51 on the lower-valued procedure. Confirm the additional procedure is not bundled under NCCI edits before appending modifier 59 or XS to bypass a bundle.

03What modifier applies if you return to the OR during the 90-day global for a complication?

Use modifier 78 for an unplanned return to the OR for a procedure related to the original patellectomy. Use modifier 79 if the return procedure is entirely unrelated.

04How do you bill a patellectomy performed during a TKA revision when the patellar component is removed along with the remaining bone?

This scenario requires careful review of the revision arthroplasty code selected. If the patellar resection is integral to the revision, it is not separately reportable as 27350. Query the surgeon and check NCCI edits for the specific revision code used.

05Is patellar bone spur removal billed as 27350?

No. Removing a bone spur from the patella without partially or completely excising the kneecap does not meet the 27350 descriptor. Use a more appropriate excision or cheilectomy code depending on the procedure performed.

06What global period applies, and what does it bundle?

27350 carries a 90-day global. That includes the day-before visit, the surgery, and all routine post-op care through day 90. Bill modifier 24 for unrelated E/M visits and modifier 25 for a same-day pre-surgical E/M addressing a separate condition.

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 extent of patellar resection (complete vs. partial), the surgical approach, intraoperative findings, and extensor mechanism reconstruction technique directly from dictation. This prevents the most common audit flag for 27350: operative notes that describe patellar work without confirming the patella was actually excised, which reviewers treat as insufficient to support the code.

See how Mira captures CPT 27350 documentation