Surgical release and lengthening of the quadriceps muscle group to restore knee flexion range of motion, typically following post-traumatic stiffness, prolonged immobilization, or prior surgery.

Verified May 8, 2026 · 8 sources ↓

Medicare: $699.08
Total RVUs: 20.93
Global, days: 90
Region: Knee

Drawn from AAPCGenhealthEmednyCgsmedicareCMS

Documentation requirements

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

Source · Editorial brief grounded in 8 cited references ↓

Preoperative knee flexion arc measured in degrees, establishing the functional deficit that necessitates surgery
Operative note identifying which of the four quadriceps muscles were involved and the specific release or lengthening technique performed (e.g., Bennett, Thompson, or modified variant)
Description of scar tissue or adhesion extent found intraoperatively — quantity and location support medical necessity and modifier 22 if applicable
Prior conservative treatment history: duration of physical therapy, manipulation under anesthesia attempts, or arthroscopic release, demonstrating surgical necessity
Anesthesia type, patient positioning, tourniquet use and time if applied, and incision approach documented in the operative report
Post-operative knee flexion achieved on the table, confirming procedural outcome and supporting continued care documentation

Applicable modifiers

Modifiers commonly billed with this code.

Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual

22 Increased complexity 51 Multiple procedures 58 Staged or related 59 Distinct service 62 Co-surgeons 78 Unplanned return — related 79 Unrelated during global 80 Assistant surgeon LT Left side RT Right side 24 Unrelated E/M during global 25 Significant separate E/M

What this code covers

Source · Editorial summary grounded in 8 cited references ↓

CPT 27430 describes a quadricepsplasty — an open surgical procedure targeting the quadriceps femoris muscle group (rectus femoris, vastus lateralis, vastus medialis, and vastus intermedius) to release adhesions, excise scar tissue, and/or lengthen the musculotendinous complex. The goal is restoring knee flexion that has been lost to fibrosis or contracture. Bennett and Thompson techniques are the named variants most commonly associated with this code. General or regional anesthesia is standard; operative time typically runs one to two hours depending on the extent of release required.

This code sits in the 90-day global period, so all routine post-op management through day 90 is bundled. Physical therapy is not bundled and is billed separately. When quadricepsplasty is performed alongside a total knee revision (27487), no automatic NCCI bundle blocks the combination — but document the distinct medical necessity of each procedure clearly. Billing 27430 with a unicompartmental arthroplasty (27446) has been flagged by coders as problematic; check current PTP edits before billing that pair.

The procedure is performed almost exclusively by orthopedic surgeons. Site of service matters: HOPD and ASC payments differ substantially — see the site-of-service comparison table on this page. Modifier 22 applies when the extent of adhesion release significantly exceeds the typical procedure; operative documentation must quantify the additional work.

RVU & reimbursement

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

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU	9.91
Practice expense RVU	8.92
Malpractice RVU	2.1
Total RVU	20.93
Medicare national rate	$699.08
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	$699.08
HOPD (APC 5114) Hospital outpatient department	$7,413.38
ASC (PI G2) Ambulatory surgical center (freestanding)	$3,695.53

Common denial reasons

The recurring reasons claims for CPT 27430 get rejected.

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

Medical necessity not established: no documented pre-op flexion deficit or failed conservative treatment course prior to open surgery
Unbundling flag when billed same-day with unicompartmental arthroplasty (27446) without supporting PTP modifier and distinct documentation
Global period conflict: post-op E/M visits billed without modifier 24 when the treating surgeon is also the operating surgeon within the 90-day window
Operative note uses generic language ('quadriceps released') without naming the technique, muscles addressed, or extent of adhesiolysis — audit trigger for lack of specificity
Modifier 22 submitted for increased complexity without a separate written justification documenting the additional time and work beyond typical quadricepsplasty

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 8 cited references ↓

01Can 27430 be billed with a total knee revision (27487) on the same day?

There is no automatic NCCI PTP bundle blocking 27430 with 27487. However, document the distinct medical necessity of the quadricepsplasty separately from the revision — operative notes that blur the two procedures together invite manual audit. Check current PTP edits before billing, as NCCI tables update quarterly.

02Can 27430 be billed with a unicompartmental knee arthroplasty (27446)?

Coding forums have flagged this combination as problematic, and multiple sources advise against it. Run both codes through the current NCCI PTP lookup tool before submitting — if a bundle edit exists with modifier indicator 0, neither a modifier nor an appeal will override it.

03What justifies modifier 22 on 27430?

Modifier 22 is appropriate when the extent of adhesiolysis or muscle lengthening substantially exceeds a typical quadricepsplasty — for example, dense post-traumatic fibrosis involving multiple muscle bellies requiring significantly longer operative time. The operative note must quantify the extra work; a cover letter with the claim should summarize why the case exceeded the norm. Payers vary on documentation thresholds.

04What is the global period for 27430, and what does it include?

27430 carries a 90-day global period. That covers the day-before visit, the surgery itself, and all routine post-op care through day 90. Unrelated E/M visits in that window need modifier 24. A new, unrelated surgery needs modifier 79. A planned staged procedure needs modifier 58.

05How does 27430 differ from arthroscopic knee release codes?

27430 is an open procedure requiring a direct incision over the quadriceps. Arthroscopic lysis of adhesions is coded differently. If the surgeon converts from arthroscopic to open during the same session, report the open code and document the reason for conversion — don't bill both the arthroscopic and open codes without a clear distinct-service modifier and supporting documentation.

06Is physical therapy after quadricepsplasty billed separately?

Yes. Physical therapy is not bundled into the 90-day global period for 27430. The operating surgeon's own routine post-op visits are bundled, but PT services rendered by a separate therapist or provider are billed independently under applicable therapy codes.

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 narrative for 27430 in real time: quadriceps muscles involved, technique name (Bennett, Thompson, or modified), extent of scar tissue and adhesions encountered, intraoperative flexion arc before and after release, and tourniquet time if used. That level of specificity prevents the two most common audit flags — generic operative language and unsupported modifier 22 claims — before the note is ever finalized.

See how Mira captures CPT 27430 documentation