Closed reduction of a knee dislocation performed without anesthesia, using manual traction and manipulation to restore tibiofemoral alignment.

Verified May 8, 2026 · 5 sources ↓

Medicare: $618.25
Work RVU: 5.83
Global, days: 90
Region: Knee

Drawn from CMSNIHAAPCFindacode

Documentation requirements

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

Source · Editorial brief grounded in 5 cited references ↓

Confirm and document the dislocation diagnosis with imaging (X-ray or MRI), noting direction of dislocation and any associated fractures or ligamentous injury
Record that no anesthesia was administered — this distinguishes 27550 from 27552 and must be explicit in the procedure note
Describe the reduction technique: traction method, patient positioning, number of attempts, and confirmation of reduction (clinical exam and/or post-reduction imaging)
Document neurovascular status before and after reduction, including distal pulses, given the high rate of vascular injury with knee dislocations
Note post-reduction immobilization applied (splint, brace type) and instructions given — even though casting/splinting is bundled, the record should reflect what was done
If additional procedures were performed in the same session, document each separately with distinct clinical indications

Applicable modifiers

Modifiers commonly billed with this code.

Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual

22 Increased complexity 25 Significant separate E/M 50 Bilateral procedure 51 Multiple procedures 52 Reduced services 57 Decision for surgery 58 Staged or related 59 Distinct service 76 Repeat, same physician 77 Repeat, another physician 78 Unplanned return — related 79 Unrelated during global LT Left side RT Right side

What this code covers

Source · Editorial summary grounded in 5 cited references ↓

CPT 27550 covers closed treatment of a knee dislocation without anesthesia — meaning the provider manually reduces the joint through controlled traction and repositioning, with no sedation or regional block used. This is distinct from 27552, which adds anesthesia, and from open surgical approaches. The code sits in the Fracture and/or Dislocation Procedures section for the femur/knee joint range.

The 90-day global period applies. That window covers the reduction, the day-before visit if applicable, and all routine follow-up through day 90 — including brace checks, wound or splint management, and any casting applied at the same setting. Separate billing for casting or splinting at the time of the reduction is not supported under NCCI policy; the post-reduction immobilization is bundled. If you're billing an E&M on the same day, it must be significant and separately identifiable with modifier 25 appended — the global rules for this 90-day procedure absorb related decision-making.

Knee dislocations frequently involve multiligamentous injury, vascular compromise, or associated fractures. If imaging reveals a concurrent fracture requiring separate manipulation or fixation, document each injury and each intervention distinctly. If a companion procedure is performed during the same session that is not bundled, apply modifier 51 or 59 as appropriate after confirming NCCI edits.

RVU & reimbursement

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

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU vs. total RVU

The work RVU (5.83) is the surgeon's own effort — the figure physician pay and productivity targets are built on. The total RVU (18.51) adds practice overhead and malpractice, and is what drives the Medicare payment below.

Work RVU	5.83
Practice expense RVU	11.35
Malpractice RVU	1.33
Total RVU	18.51
Medicare national rate	$618.25
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	$618.25
HOPD (APC 5111) Hospital outpatient department	$252.01
ASC (PI A2) Ambulatory surgical center (freestanding)	$135.54

Common denial reasons

The recurring reasons claims for CPT 27550 get rejected.

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

Anesthesia documented in the operative or procedure note without billing 27552 — payers will flag the mismatch with 27550
Same-day casting or splinting billed separately, which NCCI policy bundles into the dislocation treatment code
E&M billed same-day without modifier 25 or without documentation showing a separately identifiable service beyond the reduction decision
Insufficient documentation of the reduction technique or confirmation of realignment, triggering medical necessity denials on audit
Bilateral billing without modifier 50 or LT/RT laterality modifiers where payer policy requires them

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 5 cited references ↓

01What's the difference between 27550 and 27552?

The only distinction is anesthesia. CPT 27550 is closed reduction without anesthesia. CPT 27552 is the same procedure performed with anesthesia. If your procedure note documents sedation or a regional block, bill 27552 — billing 27550 when anesthesia was used is a code mismatch that triggers denial or overpayment recovery.

02Can I separately bill for the splint or brace applied after reducing the knee?

No. Under NCCI policy, casting and splinting applied at the same session as a musculoskeletal dislocation treatment (CPT range 20100–28899) is bundled. You cannot add a separate casting or splinting code for the same anatomic area at the same encounter.

03If I also treat an associated fracture at the same encounter, can I bill both codes?

Potentially yes, if the fracture required separate manipulation or treatment and is in a distinct anatomic area or requires a distinct intervention. Document each injury and each treatment independently. Review NCCI PTP edits for the specific code pair and apply modifier 59 or XS where appropriate to bypass a bundle.

04Does the 90-day global period prevent me from billing a follow-up MRI or ligament reconstruction within 90 days?

The global period covers routine post-op E&M visits, not separately billed diagnostic studies or unrelated procedures. An MRI ordered post-reduction is separately billable. A subsequent ligament reconstruction within 90 days is a related staged procedure — append modifier 58, not 79, since it follows from the same injury.

05When should I use modifier 22 with 27550?

Modifier 22 applies when the work is substantially greater than typical — for example, a reduction requiring multiple attempts due to muscle spasm, a complex multiligamentous dislocation with neurovascular compromise requiring prolonged management, or an unusually complex clinical scenario. You need documentation that specifically describes why the service exceeded the standard work, not just a note that it was 'difficult.'

06Is 27550 appropriate in an ASC or emergency department setting?

Yes. Closed knee reductions without anesthesia are performed in EDs and orthopedic clinics. The ASC rate and HOPD rate differ — see the site of service comparison on this page. Note that HOPD billing for the facility goes through the OPPS; the physician bills the professional component under the PFS regardless of setting.

Sources & references

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

Mira Scribe

Mira's AI scribe captures the dislocation direction, reduction technique (traction type, patient position, attempt count), absence of anesthesia, post-reduction neurovascular findings, confirmation imaging result, and immobilization applied — the exact elements auditors check when a 27550 claim is reviewed. Missing any one of these, especially the 'no anesthesia' notation or neurovascular status, is the most common reason a clean reduction note fails on post-payment audit.

See how Mira captures CPT 27550 documentation