Closed reduction of a dislocated patella performed without anesthesia.

Verified May 8, 2026 · 6 sources ↓

Medicare: $466.61
Total RVUs: 13.97
Global, days: 90
Region: Knee

Drawn from CMSCgsmedicareAAPCFindacodePayerprice

Documentation requirements

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

Source · Editorial brief grounded in 6 cited references ↓

Confirm the procedure was performed without anesthesia — document explicitly that no anesthesia was administered, distinguishing from 27562
Describe the mechanism of injury and clinical findings confirming patellar dislocation (e.g., lateral displacement, inability to extend, positive apprehension sign)
Document the reduction technique used and confirmation of successful relocation (clinical assessment or post-reduction imaging)
Record pre- and post-reduction neurovascular status of the extremity
Specify laterality (left vs. right knee) to support LT or RT modifier use and avoid claim rejection
Note any associated injuries (osteochondral fracture, ligamentous injury) that may warrant additional coding

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 52 Reduced services 58 Staged or related 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 6 cited references ↓

CPT 27560 describes manual relocation of a dislocated patella using a closed technique — no incision, no anesthesia. The physician manually guides the kneecap back into the trochlear groove without breaking the skin. This code is appropriate when the reduction is accomplished without anesthesia; if anesthesia is required, use 27562 instead.

The code carries a 90-day global period. That means the pre-operative visit (if day before or day of surgery), the reduction itself, and all routine post-op care through day 90 are bundled. Any E/M visit unrelated to the patellar dislocation during that window requires modifier 24. An E/M on the same day as the procedure requires modifier 25 if it reflects a separately identifiable service.

Common places of service are the emergency department (POS 23) and the office (POS 11). NCCI policy prohibits separately billing local anesthetic injections as an anesthesia service when performed solely to facilitate this procedure — those are bundled. If you're treating multiple dislocations or fracture-dislocation combinations stabilized with a single cast or splint, NCCI rules generally allow only one closed treatment code for the anatomic area covered by that cast.

RVU & reimbursement

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

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU	3.89
Practice expense RVU	9.17
Malpractice RVU	0.91
Total RVU	13.97
Medicare national rate	$466.61
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	$466.61
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 27560 get rejected.

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

Missing laterality documentation when LT or RT modifier is required by payer
Upcoded to 27562 without documentation supporting anesthesia use — or 27560 submitted when anesthesia was actually used
E/M billed same-day without modifier 25 when the visit preceded the reduction decision
Post-operative visit billed within the 90-day global without modifier 24, lacking documentation that the visit was for an unrelated condition
Local anesthetic injection billed separately (e.g., a nerve block code) when it was administered solely to facilitate the closed reduction — NCCI bundles this

Frequently asked questions

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

01What's the difference between 27560 and 27562?

27560 is closed patellar reduction without anesthesia. 27562 covers the same procedure when anesthesia is required. If your note doesn't explicitly document that no anesthesia was used, payers may question the code selection — document it clearly.

02Can I bill an E/M on the same day as 27560?

Yes, but only with modifier 25 and only when the E/M reflects a separately identifiable service beyond the decision to perform the reduction. A brief triage note that immediately leads to reduction doesn't qualify.

03Does the 90-day global include post-reduction imaging or follow-up MRI?

Imaging is not bundled into the global surgical package — you can bill separately for post-reduction X-rays or MRI when medically indicated. Routine office visits for the same condition are bundled through day 90.

04Is 27560 billable in the emergency department?

Yes. POS 23 (Emergency Room) is a common place of service for this code. The site of service affects payment rates — facility versus non-facility RVUs apply based on where the service is performed.

05Can I bill 27560 bilaterally if both patellae are reduced in the same session?

Bilateral patellar dislocation is rare, but if documented and clinically justified, you can bill with modifier 50. Each side requires independent documentation of dislocation, reduction technique, and confirmation of relocation.

06If the patella redislocates and I reduce it again the same day, can I bill 27560 twice?

Use modifier 76 (repeat procedure by the same physician) for a repeat reduction on the same day. Document the clinical reason for the repeat — why the first reduction failed or the joint redislocated.

07What ICD-10 codes typically pair with 27560?

S83.00x- series codes cover patellar dislocation by laterality and encounter type. Use the appropriate 7th character (A for initial encounter) and confirm laterality matches your LT or RT modifier.

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 absence of anesthesia during patellar reduction, the specific laterality, the reduction maneuver performed, and post-reduction confirmatory findings from dictation. This prevents the most common 27560 audit flag: an operative note that doesn't explicitly state no anesthesia was used, which opens the door to downcoding questions or queries about whether 27562 should have been billed instead.

See how Mira captures CPT 27560 documentation