CPT 27278
Global 090 ActiveArthrd si jt plmt iartic dev
CPT 27278 Billing & Documentation Guide
CPT code 27278 (Arthrd si jt plmt iartic dev) is classified under Surgery (Musculoskeletal) with a global period indicator of 090. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 7.66, a non-facility practice expense RVU of 403.3, and a malpractice RVU of 0.85, a total non-facility RVU of 411.81 and facility RVU of 13.15. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $14343.73, though rates vary from $11841.7 to $19723.79 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 27278, ensure documentation supports medical necessity and the specific components required for the code's level of service. For E/M codes, document MDM (medical decision-making) elements: problems addressed, data reviewed, and risk. For procedural codes, document the indication, technique, and any complications. Always verify NCCI edits before bundling 27278 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
90-day global period (major surgery: 1 day pre-op + procedure + 90 days post-op)
MUE Limit (Medically Unlikely Edits)
Submitting more than 1 units of 27278 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.
RVU Breakdown, CPT 27278
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 7.66 | 7.66 |
| Practice Expense RVU | 403.3 | 4.64 |
| Malpractice RVU | 0.85 | 0.85 |
| Total RVU | 411.81 | 13.15 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 27278
State-level averages across all MAC localities. Non-facility rates typically apply to office-based services; facility rates apply to hospital outpatient / inpatient.
| State | Non-Facility | Facility | Range (Non-Fac) | Localities |
|---|---|---|---|---|
| California | $16219.83 | $463.8 | $15039.18 - $19723.79 | 29 |
| Florida | $13826.6 | $466.62 | $13176.4 - $14350.53 | 3 |
| Georgia | $13141.14 | $438.06 | $12305.45 - $13976.83 | 2 |
| Illinois | $13326.95 | $460.75 | $12598.87 - $14142.24 | 4 |
| Michigan | $12944.69 | $441.34 | $12586.55 - $13302.83 | 2 |
| North Carolina | $12842.05 | $418.59 | $12842.05 - $12842.05 | 1 |
| New York | $15334.36 | $479.47 | $13072.86 - $16341.47 | 5 |
| Ohio | $12583.11 | $425.97 | $12583.11 - $12583.11 | 1 |
| Pennsylvania | $13482.94 | $440.31 | $12648.68 - $14317.2 | 2 |
| Texas | $13545.42 | $436.21 | $12540.46 - $14533.39 | 8 |
Source: CMS PFSRVU 2026 · Updated 2026-04-01. Full locality-level detail available for all 53 states, contact us for custom reports.
NCCI Bundling Edits, CPT 27278
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 27278 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 0709T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 11010 | Column 1 (primary), can be billed with modifier | Yes | Mutually exclusive procedures |
| 11011 | Column 1 (primary), can be billed with modifier | Yes | Mutually exclusive procedures |
| 11012 | Column 1 (primary), can be billed with modifier | Yes | Mutually exclusive procedures |
| 20650 | Column 1 (primary), can be billed with modifier | Yes | CPT Separate procedure definition |
| 20690 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 20692 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 20696 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 20900 | Column 1 (primary), can be billed with modifier | Yes | HCPCS/CPT procedure code definition |
| 20902 | Column 1 (primary), can be billed with modifier | Yes | HCPCS/CPT procedure code definition |
Frequently Asked Questions, CPT 27278
What does CPT code 27278 mean? +
CPT code 27278 represents: Arthrd si jt plmt iartic dev. It's in the Surgery (Musculoskeletal) category with a global period of 090.
What is the Medicare reimbursement for CPT 27278? +
The 2026 Medicare national average non-facility payment for CPT 27278 is $14343.73. Rates range from $11841.7 to $19723.79 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 27278? +
Surgery codes commonly use modifier 22 (increased procedural services), 50 (bilateral), 51 (multiple procedures), 52 (reduced services), 58/78/79 (staged, unplanned return, unrelated within global), 62 (co-surgeons), 80/82 (assistant surgeon), and 59 or the X{EPSU} subset for distinct procedural service.
What bundling edits apply to CPT 27278? +
This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
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