CPT 27430
Global 090 ActiveRevision of thigh muscles
CPT 27430 Billing & Documentation Guide
CPT code 27430 (Revision of thigh muscles) is classified under Surgery (Musculoskeletal) with a global period indicator of 090. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 9.91, a non-facility practice expense RVU of 8.92, and a malpractice RVU of 2.1, a total non-facility RVU of 20.93 and facility RVU of 20.93. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $708.74, though rates vary from $623.05 to $852.45 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 27430, 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 27430 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 27430 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 27430
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 9.91 | 9.91 |
| Practice Expense RVU | 8.92 | 8.92 |
| Malpractice RVU | 2.1 | 2.1 |
| Total RVU | 20.93 | 20.93 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 27430
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 | $733.44 | $733.44 | $700.76 - $834.63 | 29 |
| Florida | $766.47 | $766.47 | $721.25 - $818.54 | 3 |
| Georgia | $699.66 | $699.66 | $680.37 - $718.94 | 2 |
| Illinois | $754.08 | $754.08 | $712.65 - $793.72 | 4 |
| Michigan | $709.49 | $709.49 | $682.21 - $736.77 | 2 |
| North Carolina | $653.8 | $653.8 | $653.8 - $653.8 | 1 |
| New York | $774.43 | $774.43 | $663.35 - $836.69 | 5 |
| Ohio | $673.72 | $673.72 | $673.72 - $673.72 | 1 |
| Pennsylvania | $700.79 | $700.79 | $670.79 - $730.79 | 2 |
| Texas | $691.3 | $691.3 | $667.29 - $726.02 | 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 27430
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 27430 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 01250 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 01320 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 01400 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 01995 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 0213T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0216T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0228T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 0230T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 0596T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0597T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
Frequently Asked Questions, CPT 27430
What does CPT code 27430 mean? +
CPT code 27430 represents: Revision of thigh muscles. It's in the Surgery (Musculoskeletal) category with a global period of 090.
What is the Medicare reimbursement for CPT 27430? +
The 2026 Medicare national average non-facility payment for CPT 27430 is $708.74. Rates range from $623.05 to $852.45 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 27430? +
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 27430? +
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 June 1, 2026.
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