Closed reduction of a dislocated knee joint performed under anesthesia, without surgical incision.

Verified May 8, 2026 · 6 sources ↓

Medicare: $606.23
Work RVU: 7.98
Global, days: 90
Region: Knee

Drawn from AAPCFindacodeGenhealthPayerpriceCMS

Documentation requirements

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

Source · Editorial brief grounded in 6 cited references ↓

Document the specific dislocation pattern and which compartment(s) of the knee joint were displaced.
Record the type of anesthesia administered and the clinical rationale for its necessity.
Describe the closed reduction technique used, including traction method and directional maneuver.
Document post-reduction stability assessment, including clinical examination findings and any ligamentous laxity noted.
Include post-reduction imaging findings (X-ray or fluoroscopy) confirming joint realignment.
Note any associated neurovascular assessment performed before and after reduction, given the frequency of vascular injury with knee dislocation.
If the patient has a prosthetic knee, explicitly document the implant status — payer scrutiny increases significantly for prosthetic joint dislocations billed under 27552.

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 50 Bilateral procedure 51 Multiple procedures 52 Reduced services 58 Staged or related 59 Distinct service 76 Repeat, same physician 77 Repeat, another physician 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 27552 covers closed manipulation of a dislocated knee requiring anesthesia — meaning the bones of the knee joint are manually realigned without opening the joint. Anesthesia is required either because of patient pain/muscle guarding or to facilitate adequate reduction of the joint. This distinguishes 27552 from simpler closed treatments that do not require anesthesia.

The 90-day global period applies. That window covers the procedure, the day-before visit, and all routine post-op management through day 90 — including follow-up imaging reviews, dressing changes, and splint or brace checks directly related to the dislocation treatment. Anything unrelated billed in that window needs modifier 24 or 25.

Knee dislocation is a high-energy injury frequently accompanied by vascular, ligamentous, or neurovascular damage. The operative note must document the dislocation pattern, anesthesia type used, reduction technique, post-reduction stability assessment, and whether fluoroscopy or post-reduction imaging was performed. If closed reduction fails and open treatment is required in the same operative session, 27552 is not the correct code — select the appropriate open reduction code instead.

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 (7.98) is the surgeon's own effort — the figure physician pay and productivity targets are built on. The total RVU (18.15) adds practice overhead and malpractice, and is what drives the Medicare payment below.

Work RVU	7.98
Practice expense RVU	8.49
Malpractice RVU	1.68
Total RVU	18.15
Medicare national rate	$606.23
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	$606.23
HOPD (APC 5112) Hospital outpatient department	$1,642.82
ASC (PI A2) Ambulatory surgical center (freestanding)	$872.87

Common denial reasons

The recurring reasons claims for CPT 27552 get rejected.

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

Missing anesthesia documentation — payers deny 27552 when the record shows reduction without explicit anesthesia administration, as the companion code 27550 applies to reductions without anesthesia.
Diagnosis code mismatch — ICD-10 codes for knee sprain or subluxation instead of true dislocation (S83.1xx) trigger automatic downcoding or denial.
Global period conflicts — services billed within the 90-day post-op window of a prior knee procedure without modifier 24 or 79 are routinely denied.
Modifier 78 incorrectly applied — if this reduction occurs after a prior unrelated knee procedure, modifier 79 (unrelated procedure in global period) is correct; using 78 triggers denial when relatedness cannot be established.
Insufficient operative note — reduction documented as 'performed without complication' with no technique, anesthesia type, or post-reduction imaging cited is a common audit and denial trigger.

Frequently asked questions

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

01What is the difference between CPT 27550 and 27552?

27550 is closed treatment of knee dislocation without anesthesia. 27552 requires anesthesia — general, regional, or IV sedation — to accomplish the reduction. The anesthesia must be documented; you cannot bill 27552 based on intent alone.

02Can 27552 be billed for a dislocated prosthetic knee?

There is no dedicated CPT code for closed reduction of a dislocated total knee prosthesis, unlike the hip (27265/27266). Per AAPC coding forum guidance, 27552 is the closest available code for this scenario. Document the prosthetic status explicitly and expect payer scrutiny — some carriers may request additional review.

03Which modifier applies if this reduction occurs during the global period of a prior knee surgery?

Use modifier 78 if the dislocation is directly related to the prior procedure (e.g., post-op instability leading to dislocation). Use modifier 79 if the dislocation is unrelated to the prior procedure — for example, a traumatic dislocation after a motor vehicle accident in a patient recovering from a prior unrelated knee surgery. Do not invert these.

04Does the 90-day global period for 27552 include post-reduction brace management?

Yes. Routine brace checks, splint adjustments, and follow-up visits directly related to the dislocation treatment are bundled into the 90-day global. Bill separately only for services unrelated to the dislocation, appending modifier 24 to the E/M code.

05Is fluoroscopy separately billable when performed during closed knee reduction under 27552?

Fluoroscopic guidance used intraoperatively to confirm reduction is generally considered bundled with the procedural code and is not separately billable. Post-reduction plain films in the same session may be separately billable depending on payer policy — confirm with the specific payer before billing.

06What ICD-10 codes support 27552?

The primary diagnosis should reflect traumatic knee dislocation — S83.1xx series codes with the appropriate laterality and encounter type. Avoid sprains (S83.4xx–S83.6xx) or subluxation codes; these create a diagnosis-to-procedure mismatch that payers flag automatically.

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 pattern, anesthesia type and rationale, step-by-step reduction technique, post-reduction stability exam findings, and imaging confirmation directly from the surgeon's dictation. This prevents the most common denial trigger for 27552 — an operative note that documents the outcome but omits the method and anesthesia necessity, leaving coders unable to distinguish 27552 from the non-anesthesia companion code 27550.

See how Mira captures CPT 27552 documentation