Surgical · Knee

Manipulation of the knee joint performed under general anesthesia, including application of traction or other fixation devices as needed to restore range of motion.

Verified May 8, 2026 · 7 sources ↓

Medicare: $149.97
Total RVUs: 4.49
Global, days: 10
Region: Knee

Drawn from CMSPabauPayerpriceFindacodeAAPC

Documentation requirements

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

Source · Editorial brief grounded in 7 cited references ↓

Confirm general anesthesia was used — document anesthesia type explicitly in the operative note
Record preoperative range of motion measurements and the degree achieved post-manipulation
Document failed conservative treatment (physical therapy, home exercise) prior to scheduling the procedure
Identify the underlying diagnosis driving stiffness (e.g., arthrofibrosis, status post TKA) with a specific ICD-10 code
Note whether traction or fixation devices were applied during the procedure
Confirm the procedure was performed as a standalone intervention, not incidental to another knee procedure

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 58 Staged or related 59 Distinct service 73 Discontinued pre-anesthesia 74 Discontinued post-anesthesia 76 Repeat, same physician 77 Repeat, another physician 78 Unplanned return — related 79 Unrelated during global 80 Assistant surgeon AS PA/NP/CNS assistant LT Left side RT Right side XS Separate structure

What this code covers

Source · Editorial summary grounded in 7 cited references ↓

CPT 27570 covers manipulation of a stiff or fibrotic knee joint under general anesthesia. The procedure is most commonly performed to break down adhesions after total knee arthroplasty or other knee surgery when postoperative range of motion has failed to meet functional goals despite conservative rehab. General anesthesia is a code requirement — analgesia or sedation short of general anesthesia doesn't satisfy the descriptor.

The 10-day global period means routine follow-up through day 10 is bundled. Any E/M visit on the same day for a separate problem needs modifier 25. If a related complication brings the patient back to the OR within the global, that's modifier 78. An unrelated procedure in the global window uses modifier 79.

NCCI policy explicitly prohibits billing 27570 separately when joint manipulation is performed during another procedure in the same anatomical area — for example, during knee arthroscopy. The manipulation is considered integral to the primary procedure in that scenario. Traction application, when performed as part of this procedure, is bundled and not separately reportable.

RVU & reimbursement

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

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU	1.75
Practice expense RVU	2.37
Malpractice RVU	0.37
Total RVU	4.49
Medicare national rate	$149.97
Global period	10 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	$149.97
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 27570 get rejected.

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

Anesthesia type not documented as general anesthesia — sedation or regional block noted instead
No documented evidence of failed conservative range-of-motion therapy prior to the procedure
Bundled into a same-day knee arthroscopy under NCCI policy — manipulation is not separately payable when performed during a related procedure in the same anatomical area
Missing pre- and post-procedure range of motion measurements, leaving medical necessity unsupported
Incorrect modifier applied when billed during the global period of a prior knee procedure

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 7 cited references ↓

01Can 27570 be billed on the same day as a knee arthroscopy?

No. NCCI policy explicitly states that joint manipulation under anesthesia is not separately reportable when performed during another procedure in the same anatomical area. 27570 bundles into same-day knee arthroscopy codes.

02What is the global period for 27570?

10-day global. Routine follow-up through day 10 is bundled. An E/M for a separate, unrelated problem on the same day needs modifier 25; a related return to the OR in the global window needs modifier 78.

03Does sedation qualify for billing 27570, or is general anesthesia required?

General anesthesia is a code requirement. Sedation or regional nerve block alone does not satisfy the descriptor. Document the anesthesia type explicitly — auditors flag operative notes that are vague on this point.

04What diagnosis codes most commonly support 27570?

Arthrofibrosis of the knee and stiffness following total knee arthroplasty are the primary drivers. Use the most specific ICD-10 available, such as M25.661/M25.662 for stiffness or a status-post TKA complication code. Mismatched CPT-to-ICD pairing is a top denial trigger.

05If the patient returns for manipulation within the global period of their TKA, what modifier applies?

Modifier 58 if the manipulation was planned or staged at the time of the original TKA. Modifier 78 if the return was unplanned but the indication is related to the original procedure. Do not use 79 for a stiffness complication of the index surgery.

06Is traction application billed separately alongside 27570?

No. The code descriptor includes application of traction or other fixation devices. Billing a separate traction code on the same date will be denied as bundled.

07What site of service is most common for 27570?

ASC and on-campus outpatient hospital (HOPD) are the predominant settings. Payment differs between sites — see the Site of Service comparison on this page. Facility billing requirements and anesthesia documentation expectations are consistent across both.

Sources & references

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

Mira AI Scribe

Mira's AI scribe captures anesthesia type, pre- and post-manipulation range of motion measurements, the specific diagnosis driving stiffness, prior conservative treatment history, and whether traction or fixation devices were applied. That documentation set directly prevents the two most common denials: wrong anesthesia type on record and unsupported medical necessity due to missing ROM data or absent conservative-care history.

See how Mira captures CPT 27570 documentation