Closed reduction of a dislocated patella requiring anesthesia, performed without an incision to restore the kneecap to its normal anatomical position.

Verified May 8, 2026 · 6 sources ↓

Medicare: $476.30
Total RVUs: 14.26
Global, days: 90
Region: Knee

Drawn from CMSAAPCMdclarityFindacodeAAOS

Documentation requirements

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

Source · Editorial brief grounded in 6 cited references ↓

Confirmation that the procedure was closed (no incision made)
Type of anesthesia used and that anesthesia was required for reduction
Laterality documented — left, right, or bilateral
Acute versus recurrent dislocation status explicitly stated
Pre- and post-reduction clinical findings including patella position
Physician narrative confirming successful reduction and post-procedure stability assessment

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 58 Staged or related 59 Distinct service 76 Repeat, same 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 ↓

27562 covers closed treatment of a patellar dislocation when anesthesia is required to complete the reduction. No incision is made — the patella is manipulated back into the trochlear groove manually. The anesthesia requirement is what separates this code from 27560, which covers the same reduction performed without anesthesia. If the physician opens the joint, the correct code is 27566, not 27562.

The 90-day global period begins on the day of the procedure. Routine post-reduction follow-up visits, splinting, and dressing changes within that window are bundled. Separately billable E/M services during the global period need modifier 24 (unrelated) or modifier 25 (same-day, significant and separately identifiable). If the dislocation is recurrent and requires a stabilization procedure rather than simple reduction, a different code family applies entirely.

For ICD-10 pairing, confirm laterality (left vs. right) and whether the dislocation is initial encounter or subsequent — payers will reject a vague or unspecified laterality code when a more specific option exists. The distinction between acute and recurrent dislocation also drives code selection both on the CPT and ICD-10 sides, so the operative note must make that determination explicit.

RVU & reimbursement

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

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU	5.83
Practice expense RVU	7.18
Malpractice RVU	1.25
Total RVU	14.26
Medicare national rate	$476.30
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	$476.30
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 27562 get rejected.

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

Miscoded laterality or unspecified ICD-10 code when a specific code is available
Upcoded to 27566 (open treatment) when operative note documents no incision
Downcoded to 27560 due to missing or inadequate anesthesia documentation
Bundling denial when a same-day E/M is billed without modifier 25
Global period violation — post-op routine visit billed without modifier 24

Frequently asked questions

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

01What separates 27562 from 27560?

Anesthesia. Both codes describe closed patellar dislocation treatment, but 27562 applies when anesthesia is required to achieve reduction. If no anesthesia was used, 27560 is correct. The operative note must state anesthesia was necessary — vague documentation gets downcoded.

02When should 27566 be used instead of 27562?

27566 is for open treatment — the joint was entered surgically, with or without partial or total patellectomy. If the skin was not broken, 27566 is wrong. Payers and auditors flag this substitution frequently.

03Can 27562 be billed for a recurrent patellar dislocation?

No. The 27562 family (27560, 27562, 27566) applies to acute dislocations. Recurrent patellar dislocations requiring stabilization procedures fall under a different code set. Document acute versus recurrent status in the operative note — it drives both CPT and ICD-10 selection.

04How does the 90-day global period affect post-op billing?

All routine follow-up care through day 90 is bundled into 27562. To bill a separate E/M during the global period, you need modifier 24 for an unrelated visit or modifier 25 for a same-day significant and separately identifiable service. Bill a same-day injection or unrelated procedure with modifier 79.

05Is modifier 50 appropriate if both knees are treated in the same session?

Yes. If bilateral patellar dislocations are reduced in the same encounter, append modifier 50 to 27562. Expect the second-side allowable to be reduced — typically 50% of the primary procedure rate. Document both sides in the operative note.

06What ICD-10 codes pair with 27562?

Use codes from the S83.0x- series (traumatic dislocation of patella) with the appropriate laterality character. Confirm initial versus subsequent encounter status for the seventh character. Payers reject unspecified laterality when left or right is documented in the note.

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 closed nature of the reduction, the anesthesia type and necessity, pre- and post-reduction patellar position, and explicit laterality from the physician's dictation. This prevents the two most common 27562 denials: missing anesthesia documentation that triggers a downcode to 27560, and unspecified laterality that causes ICD-10 mismatch rejections.

See how Mira captures CPT 27562 documentation