Home / Medicare fees / 27331

27331 Explore/treat knee joint

What 27331 is

CMS fee schedule short descriptor: Explore/treat knee joint.

Full CPT long descriptions are licensed by the American Medical Association and are not published on this site; the short descriptor above is the one CMS prints in its own fee schedule file. See About CPT.

Medicare payment for 27331 (CY2026)

Work RVUPractice expense RVUMalpractice RVUTotalMedicare rate
Non-facility (office)5.876.661.2313.76$459.60
Facility (hospital, ASC)5.876.661.2313.76$459.60

National rates: total RVUs x the CY2026 conversion factor of 33.4009 (non-QP), before geographic adjustment. Actual Medicare payment is 80% of the rate shown after the deductible; the patient or secondary payer owes the 20% coinsurance.


Status: Active - payable under the Physician Fee Schedule. Global period: 90-day global period.

Advertisement

Medically Unlikely Edit (MUE)

Medicare caps 27331 at 1 unit per date of service for practitioner claims (MAI 2 - date of service edit (absolute): units above the MUE never pay), rationale: CMS Policy. Units above the cap are denied unless the edit's adjudication rules allow an appeal with documentation.

Billed with 27331? These codes are bundled into it

27331 is a Column 1 code in 280 active NCCI PTP edits. When one of these Column 2 codes is reported on the same date of service, it is denied as bundled - unless the edit's modifier indicator is 1 and documentation supports a distinct service with an NCCI-associated modifier.

Column 2 codeShort descriptionModifier indicator
01250Anes all px nrv musc upr leg0 - no modifier bypassCheck pair
01320Anes all px nrv msc kne&/pop0 - no modifier bypassCheck pair
01400Anes opn/arthrs knee jt nos0 - no modifier bypassCheck pair
0213TNjx paravert w/us cer/thor0 - no modifier bypassCheck pair
0216TNjx paravert w/us lumb/sac0 - no modifier bypassCheck pair
0566TAutol cell implt adps njx1 - modifier may bypassCheck pair
0596TTemp fml iu vlv-pmp 1st insj1 - modifier may bypassCheck pair
0597TTemp fml iu valve-pmp rplcmt1 - modifier may bypassCheck pair
0708TId ca immntx prep & 1st njx1 - modifier may bypassCheck pair
0709TId ca immntx each addl njx1 - modifier may bypassCheck pair
0903TEcg alg 12 lead reduced i&r1 - modifier may bypassCheck pair
0904TEcg alg 12 ld rdcd trcg only1 - modifier may bypassCheck pair
0905TEcg alg 12 ld rdcd i&r only1 - modifier may bypassCheck pair
10005Fna bx w/us gdn 1st les1 - modifier may bypassCheck pair
10007Fna bx w/fluor gdn 1st les1 - modifier may bypassCheck pair
10009Fna bx w/ct gdn 1st les1 - modifier may bypassCheck pair
10011Fna bx w/mr gdn 1st les1 - modifier may bypassCheck pair
10021Fna bx w/o img gdn 1st les1 - modifier may bypassCheck pair
10030Img gid flu coll drg sft tis1 - modifier may bypassCheck pair
10060I&d abscess simple/single1 - modifier may bypassCheck pair
10140I&d hmtma seroma/fluid collj1 - modifier may bypassCheck pair
10160Pnxr aspir absc hmtma bulla1 - modifier may bypassCheck pair
11000Dbrdmt ecz/infected skin<10%1 - modifier may bypassCheck pair
11001Dbrdmt ecz/infct skn ea addl1 - modifier may bypassCheck pair
11004Dbrdmt skin xtrnl gent&per1 - modifier may bypassCheck pair
11005Dbrdmt skin abdominal wall1 - modifier may bypassCheck pair
11006Dbrdmt skin xtrnl gent per1 - modifier may bypassCheck pair
11012Deb skin bone at fx site1 - modifier may bypassCheck pair
11042Dbrdmt subq tis 1st 20sqcm/<1 - modifier may bypassCheck pair
11043Dbrdmt musc&/fsca 1st 20/<1 - modifier may bypassCheck pair

Showing 30 of 280 column 2 codes. Use the pair checker for any specific combination.

27331 is bundled into these codes

27331 appears as a Column 2 code in 55 active edits. Reported with one of these Column 1 codes on the same date of service, 27331 is the code that denies.

Column 1 codeShort descriptionModifier indicator
11010Debride skin at fx site1Check pair
11011Debride skin musc at fx site1Check pair
27345Removal of knee cyst1Check pair
27347Remove knee cyst1Check pair
27350Removal of kneecap1Check pair
27365Resect femur/knee tumor1Check pair
27380Repair of kneecap tendon1Check pair
27381Repair/graft kneecap tendon1Check pair
27385Repair of thigh muscle1Check pair
27403Repair of knee cartilage1Check pair
27405Repair of knee ligament1Check pair
27407Repair of knee ligament1Check pair
27409Repair of knee ligaments1Check pair
27412Autochondrocyte implant knee1Check pair
27415Osteochondral knee allograft1Check pair

Data: CMS CY2026 Physician Fee Schedule RVU file (October release, RVU26D) and Medicare NCCI PTP practitioner edits v32.3 (2026 Q4). Verify against the official files before billing or contracting decisions.