Tibial plateau arthroplasty of the knee with debridement and partial synovectomy performed at the same operative setting.

Verified May 8, 2026 · 6 sources ↓

Medicare: $768.55
Total RVUs: 23.01
Global, days: 90
Region: Knee

Drawn from CMSZimmerbiometCgsmedicareFindacodeAAPC

Documentation requirements

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

Source · Editorial brief grounded in 6 cited references ↓

Operative note must name the specific tibial plateau resurfacing technique and implant used — 'tibial plateau arthroplasty' alone is insufficient for audit purposes.
Document the debridement findings separately: tissue type removed, extent, and clinical rationale — debridement is definitionally included but auditors look for evidence it was actually performed.
Partial synovectomy extent must be described (e.g., anterior compartment, medial gutter); 'synovectomy performed' without anatomical detail is a common audit flag.
Pre-op imaging (X-ray or MRI) confirming isolated tibial plateau pathology to support medical necessity and justify 27441 over a more comprehensive arthroplasty code.
Diagnosis codes must reflect isolated or dominant tibial plateau disease; a diagnosis mapping to full tricompartmental arthritis invites downcoding scrutiny.
Laterality must be clearly documented in both the op note and on the claim — LT or RT modifier is required for bilateral-capable procedures.

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 25 Significant separate E/M 51 Multiple procedures 52 Reduced services 57 Decision for surgery 58 Staged or related 62 Co-surgeons 78 Unplanned return — related 79 Unrelated during global 80 Assistant surgeon LT Left side RT Right side

What this code covers

Source · Editorial summary grounded in 6 cited references ↓

CPT 27441 covers resurfacing or reconstruction of the tibial plateau combined with joint debridement and partial removal of the synovial lining. This is a unicompartmental-level procedure targeting the tibial side of the joint — it is not a total knee replacement. The debridement and partial synovectomy are bundled into 27441 by definition; do not separately report those steps.

The key distinction within this code family: 27440 is the tibial plateau arthroplasty without debridement or synovectomy; 27441 adds those steps. Code 27442 moves to the femoral condyle(s) or tibial plateau(s) — a different anatomical scope. Per the NCCI Correspondence Language Manual, 27441 and 27442 are mutually exclusive for the same knee on the same date; only one is payable.

The 90-day global period applies. All routine post-op visits, wound checks, and stitch removals through day 90 are included. Unrelated services in that window require modifier 24 or 25; a staged or related return to the OR requires modifier 78 or 79 depending on relatedness.

RVU & reimbursement

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

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU	11.25
Practice expense RVU	9.36
Malpractice RVU	2.4
Total RVU	23.01
Medicare national rate	$768.55
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	$768.55
HOPD (APC 5115) Hospital outpatient department	$13,116.76
ASC (PI G2) Ambulatory surgical center (freestanding)	$6,804.43

Common denial reasons

The recurring reasons claims for CPT 27441 get rejected.

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

Code billed alongside 27442 for the same knee on the same date — NCCI treats these as mutually exclusive; only the higher-valued code pays.
Diagnosis code reflects tricompartmental or total knee pathology, triggering medical necessity denial when a partial arthroplasty code is submitted.
Missing laterality modifier (LT or RT) causing claim rejection or pended status at many regional MACs.
Separate line-item billing for debridement or synovectomy that is already bundled into 27441 by the code descriptor, resulting in NCCI component-bundle denial.
Global period conflict — post-op E/M visits submitted without modifier 24 within the 90-day window are denied as included in the global package.

Frequently asked questions

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

01What is the difference between 27440 and 27441?

27440 is tibial plateau arthroplasty alone. 27441 is the same procedure plus intraoperative debridement and partial synovectomy. If those additional steps were performed and documented, 27441 is the correct code — do not bill 27440 and then attempt to add separate debridement codes.

02Can 27441 and 27442 be billed together for the same knee?

No. CMS NCCI treats 27441 and 27442 as mutually exclusive for the same knee on the same date. These codes describe different anatomical scopes of tibial plateau or femoral condyle arthroplasty; only one is payable per session.

03Does 27441 carry a global period, and what does it include?

Yes — 90-day global. The day-before-surgery visit, the procedure day, and all routine post-op care through day 90 are bundled. Bill unrelated E/M visits in that window with modifier 24; bill unrelated procedures with modifier 79.

04Which laterality modifier is required?

Always append LT or RT. Most MACs and commercial payers require laterality on knee procedures. Claims without it will reject or pend at clearinghouse level before adjudication.

05Is 27441 appropriate for a patient with tricompartmental arthritis?

Generally no. 27441 is a tibial plateau — not a total knee — arthroplasty. If the operative note and diagnosis support full compartmental disease, 27447 (total knee arthroplasty) is the more accurate code. Submitting 27441 against a tricompartmental diagnosis invites medical necessity denial and potential audit exposure.

06Can the partial synovectomy included in 27441 be billed separately?

No. Debridement and partial synovectomy are definitionally bundled into 27441. Billing a synovectomy or debridement code alongside 27441 for the same knee on the same date will trigger an NCCI component-bundle denial.

07What HCPCS device code applies when 27441 is billed in the outpatient setting?

C1776 (implantable joint device) is the appropriate HCPCS Level II code to report the tibial plateau implant when billing under OPPS. Implant costs are not separately payable for most ASC cases under the G2 payment indicator assigned to 27441.

Sources & references

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

Mira AI Scribe

The Mira AI Scribe captures the tibial plateau approach, implant type and fixation method, extent of debridement (tissue type and anatomical zone), and the specific region of partial synovectomy from the surgeon's dictation. It also flags when bilateral language appears in the note so the correct laterality modifier is applied automatically. This prevents the two most common 27441 denials: missing laterality and unbundled debridement lines that auditors pull on post-payment review.

See how Mira captures CPT 27441 documentation