Injection · Knee

Injection of contrast material into the knee joint in preparation for contrast knee arthrography, contrast-enhanced CT arthrography, or contrast-enhanced MRI arthrography.

Verified May 8, 2026 · 7 sources ↓

Medicare: $181.70
Total RVUs: 5.44
Global, days: 0
Region: Knee

Drawn from CMSMdclarityAAPCFindacodePayerprice

Documentation requirements

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

Source · Editorial brief grounded in 7 cited references ↓

Indication for contrast arthrography — clinical question the imaging is intended to answer (e.g., suspected cartilage defect, ligament tear, post-surgical evaluation)
Laterality documented explicitly (right knee or left knee) in both the order and the procedure note
Technique note confirming intra-articular needle placement and contrast injection, including contrast agent name and volume administered
Confirmation that the injection was performed specifically in preparation for contrast arthrography, CT arthrography, or MRI arthrography — not a standalone therapeutic injection
Supervising or performing physician identity and direct involvement, particularly in hospital outpatient settings where split/shared rules apply
If billing an E/M same-day, separate documentation demonstrating a distinct medical decision-making encounter beyond the injection itself

Applicable modifiers

Modifiers commonly billed with this code.

Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual

25 Significant separate E/M 26 Professional component 50 Bilateral procedure 51 Multiple procedures 52 Reduced services LT Left side RT Right side 59 Distinct service XS Separate structure

What this code covers

Source · Editorial summary grounded in 7 cited references ↓

CPT 27369 covers the intra-articular injection of contrast agent into the knee joint performed specifically to enhance visualization during arthrography, CT arthrography, or MRI arthrography. The injection itself is the billable service here — it opacifies the joint space so that structures like articular cartilage, ligaments, and the joint capsule are more clearly delineated on subsequent imaging. The code sits in the Introduction or Removal Procedures section for the femur/knee joint and carries a 000-day global period, meaning same-day E/M or other separately identifiable services can be billed with modifier 25 if documentation supports them.

This code covers the injection procedure only. The imaging interpretation (radiology read) is billed separately under the appropriate radiology CPT code (e.g., 73580 for knee arthrography fluoroscopy, 73701/73702 for CT, or 73723 for MRI arthrography). When the performing provider owns the equipment and personally interprets the images, they may bill both 27369 and the relevant radiology code. If only performing the injection, bill 27369 without a component modifier. If only reading the images, bill the imaging code with modifier 26.

Side-specific modifiers LT and RT are standard on knee codes and payers expect them. Omitting laterality is a routine reason for payer rejection. The procedure is most commonly performed in an office or outpatient hospital setting; HOPD and ASC facility payments are not separately established under the Medicare fee schedule for this code.

RVU & reimbursement

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

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU	0.75
Practice expense RVU	4.61
Malpractice RVU	0.08
Total RVU	5.44
Medicare national rate	$181.70
Global period	0 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	$181.70

Common denial reasons

The recurring reasons claims for CPT 27369 get rejected.

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

Missing laterality modifier — payers routinely reject knee codes submitted without LT or RT
Bundling conflict when the imaging code and 27369 are billed without understanding which components the performing provider actually owns and performed
Lack of medical necessity documentation — payer policy requires documented clinical indication supporting contrast arthrography over standard MRI or CT
Incorrect use of modifier 26 or TC — billing the full code when only the injection was performed, or vice versa
Same-day E/M denied without modifier 25 when the visit note does not contain a separately identifiable problem-focused encounter distinct from the injection

Frequently asked questions

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

01Does 27369 include the imaging interpretation, or just the injection?

Just the injection. Bill the appropriate radiology code (e.g., 73580 for fluoroscopic arthrography, 73723 for MRI arthrography, 73701/73702 for CT arthrography) separately for the imaging and its interpretation. If you performed both, bill both codes. If you only performed the injection, bill only 27369.

02When does modifier 26 apply to 27369?

It doesn't — 27369 is a surgical procedure code covering the injection only, and it doesn't split into a professional/technical component the way radiology codes do. Apply modifier 26 to the imaging code (e.g., 73723-26) if you're billing only for the interpretation of the imaging study.

03Should I bill LT or RT on every claim for 27369?

Yes. Laterality modifiers are expected on all unilateral knee procedure codes. Claims submitted without LT or RT are routinely rejected by Medicare and most commercial payers. Bilateral knee arthrography on the same date is rare but would use modifier 50.

04Can 27369 be billed same-day as an office visit?

Yes, but the E/M requires modifier 25 and documentation of a separately identifiable medical decision-making encounter. If the visit note only documents the decision to perform the injection and nothing else, the E/M will be denied.

05What ICD-10 diagnoses most commonly support 27369?

Common supporting diagnoses include internal derangement of the knee (M23.xx), articular cartilage disorders (M94.26x), joint effusion (M25.36x), and post-surgical evaluation indications. The diagnosis should reflect the clinical question driving the arthrography, not a generic knee pain code alone.

06Is 27369 payable in an ASC or HOPD facility?

Per CMS Physician Fee Schedule 2026, no separate facility payment is established for 27369 in HOPD or ASC settings. The physician component is still billable on a professional claim. Verify your facility's payer contracts for commercial payment rules.

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 intra-articular injection technique, contrast agent and volume used, needle placement confirmation, laterality, and the specific imaging modality ordered (arthrography, CT arthrography, or MRI arthrography) directly from the physician's dictation. This prevents the two most common denials for 27369: missing laterality and insufficient documentation tying the injection to a contrast imaging study rather than a therapeutic procedure.

See how Mira captures CPT 27369 documentation