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Official Description

Revision of total knee arthroplasty, with or without allograft; femoral and entire tibial component

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

The procedure described by CPT® Code 27487 refers to the revision of a total knee arthroplasty, which is a surgical intervention aimed at correcting issues related to a previously implanted knee prosthesis. This revision may be necessary due to various complications, including mechanical failures of the implant or complications such as infections. During this procedure, both the femoral and tibial components of the knee prosthesis may be revised, which involves a comprehensive approach to address the underlying issues effectively. The surgical process begins with a long incision that is strategically made over the femur, extending down over the knee and onto the tibia. This allows the surgeon to access the knee joint while carefully dissecting the surrounding soft tissues, ensuring the protection of vital nerves and blood vessels. The removal of the existing femoral and/or tibial components is followed by an evaluation of any bone loss that may have occurred. If significant bone loss is identified, a bone allograft may be utilized, which is sourced from a bone bank and shaped to fit the defect. The procedure may also involve the use of internal devices, such as metallic cages, plates, and screws, to restore the bone's structural integrity. After reconstructing the bone, a new prosthesis is implanted, and if necessary, adjustments are made to the knee ligaments to ensure proper function. The procedure concludes with the evaluation of patellofemoral tracking and the securement of the new components, ensuring that the knee joint functions optimally post-surgery.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The revision of total knee arthroplasty, as described by CPT® Code 27487, is indicated for the following conditions:

  • Mechanical Complications The procedure may be performed to address mechanical failures of the knee implant, which can include issues such as loosening, instability, or malalignment of the prosthetic components.
  • Infection Revision may be necessary in cases where there is an infection associated with the knee prosthesis, which can compromise the integrity and function of the implant.
  • Bone Loss Significant bone loss around the knee joint may necessitate a revision to restore proper support and alignment of the knee components.
  • Patellofemoral Degenerative Joint Disease The presence of significant degenerative changes in the patellofemoral joint may require intervention to improve joint function and alleviate pain.

2. Procedure

The procedure for the revision of total knee arthroplasty involves several critical steps:

  • Incision A long incision is made starting over the femur, extending down over the knee and onto the tibia, providing access to the knee joint.
  • Soft Tissue Dissection The surgeon carefully dissects the soft tissues surrounding the knee, taking precautions to protect nerves and blood vessels during the procedure.
  • Removal of Components The existing femoral and/or tibial components of the knee prosthesis are removed to allow for evaluation and reconstruction.
  • Evaluation of Bone Loss The surgeon assesses the extent of any bone loss that has occurred, which is critical for determining the need for a bone allograft.
  • Bone Allograft Utilization If a bone allograft is required, it is obtained from a bone bank and shaped to fit the defect, or cancellous bone may be morcellized and packed into the defect.
  • Internal Device Application Internal devices such as metallic cages, plates, and screws may be utilized to restore bone length and stability as needed.
  • Implantation of New Prosthesis Once the bone reconstruction is complete, a new prosthesis is implanted to restore knee function.
  • Ligament Release If knee ligaments are contracted, they are released to ensure proper alignment and function of the knee joint.
  • Trial Components Placement Trial components are placed to evaluate patellofemoral tracking, ensuring that the new components function correctly.
  • Patellofemoral Adjustments Lateral release or medial reefing is performed as necessary to achieve proper patellofemoral tracking, and if significant degenerative joint disease is present, the patella may be resurfaced with a polyethylene button.
  • Securing the Components If an unlinked type of prosthesis is used, the femoral component is secured using either a press-fit technique or bone cement, followed by the tibial component, which consists of a metal tray and plastic spacing device secured to the proximal tibia.
  • Hinged Prosthesis Insertion If a hinged prosthesis is utilized, the stem is inserted into the femur and secured using a press-fit technique or bone cement, with the tibial stem secured in a similar manner.
  • Range of Motion Evaluation The range of motion of the knee is evaluated to ensure proper function post-implantation.
  • Closure Finally, the soft tissues and skin are closed in layers to complete the procedure.

3. Post-Procedure

Post-procedure care following the revision of total knee arthroplasty includes monitoring for any signs of complications, such as infection or improper healing. Patients are typically advised on rehabilitation protocols to restore mobility and strength in the knee joint. Physical therapy may be initiated to assist in regaining range of motion and functional capabilities. Follow-up appointments are essential to assess the success of the revision and to ensure that the new components are functioning as intended. Pain management strategies will also be discussed to facilitate recovery.

Short Descr REVISE/REPLACE KNEE JOINT
Medium Descr REVJ TOT KNEE ARTHRP FEM&ENTIRE TIBIAL COMPONE
Long Descr Revision of total knee arthroplasty, with or without allograft; femoral and entire tibial component
Status Code Active Code
Global Days 090 - Major Surgery
PC/TC Indicator (26, TC) 0 - Physician Service Code
Multiple Procedures (51) 2 - Standard payment adjustment rules for multiple procedures apply.
Bilateral Surgery (50) 1 - 150% payment adjustment for bilateral procedures applies.
Physician Supervisions 09 - Concept does not apply.
Assistant Surgeon (80, 82) 2 - Payment restriction for assistants at surgery does not apply to this procedure...
Co-Surgeons (62) 1 - Co-surgeons could be paid, though supporting documentation is required...
Team Surgery (66) 0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator Inpatient Procedures, not paid under OPPS
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) P3D - Major procedure, orthopedic - other
MUE 1
CCS Clinical Classification 152 - Arthroplasty knee

This is a primary code that can be used with these additional add-on codes.

20704 Add-on Code MPFS Status: Active Code APC N Manual preparation and insertion of drug-delivery device(s), intra-articular (List separately in addition to code for primary procedure)
20705 Add-on Code MPFS Status: Active Code APC N Removal of drug-delivery device(s), intra-articular (List separately in addition to code for primary procedure)
RT Right side (used to identify procedures performed on the right side of the body)
LT Left side (used to identify procedures performed on the left side of the body)
AS Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery
22 Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service.
GC This service has been performed in part by a resident under the direction of a teaching physician
52 Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use).
58 Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78.
80 Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s).
78 Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.)
82 Assistant surgeon (when qualified resident surgeon not available): the unavailability of a qualified resident surgeon is a prerequisite for use of modifier 82 appended to the usual procedure code number(s).
50 Bilateral procedure: unless otherwise identified in the listings, bilateral procedures that are performed at the same session, should be identified by adding modifier 50 to the appropriate 5 digit code. note: this modifier should not be appended to designated "add-on" codes (see appendix d).
51 Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d).
53 Discontinued procedure: under certain circumstances, the physician or other qualified health care professional may elect to terminate a surgical or diagnostic procedure. due to extenuating circumstances or those that threaten the well being of the patient, it may be necessary to indicate that a surgical or diagnostic procedure was started but discontinued. this circumstance may be reported by adding modifier 53 to the code reported by the individual for the discontinued procedure. note: this modifier is not used to report the elective cancellation of a procedure prior to the patient's anesthesia induction and/or surgical preparation in the operating suite. for outpatient hospital/ambulatory surgery center (asc) reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use).
54 Surgical care only: when 1 physician or other qualified health care professional performs a surgical procedure and another provides preoperative and/or postoperative management, surgical services may be identified by adding modifier 54 to the usual procedure number.
55 Postoperative management only: when 1 physician or other qualified health care professional performed the postoperative management and another performed the surgical procedure, the postoperative component may be identified by adding modifier 55 to the usual procedure number.
56 Preoperative management only: when 1 physician or other qualified health care professional performed the preoperative care and evaluation and another performed the surgical procedure, the preoperative component may be identified by adding modifier 56 to the usual procedure number.
59 Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25.
62 Two surgeons: when 2 surgeons work together as primary surgeons performing distinct part(s) of a procedure, each surgeon should report his/her distinct operative work by adding modifier 62 to the procedure code and any associated add-on code(s) for that procedure as long as both surgeons continue to work together as primary surgeons. each surgeon should report the co-surgery once using the same procedure code. if additional procedure(s) (including add-on procedure(s) are performed during the same surgical session, separate code(s) may also be reported with modifier 62 added. note: if a co-surgeon acts as an assistant in the performance of additional procedure(s), other than those reported with the modifier 62, during the same surgical session, those services may be reported using separate procedure code(s) with modifier 80 or modifier 82 added, as appropriate.
76 Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service.
77 Repeat procedure by another physician or other qualified health care professional: it may be necessary to indicate that a basic procedure or service was repeated by another physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 77 to the repeated procedure or service. note: this modifier should not be appended to an e/m service.
79 Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.)
81 Minimum assistant surgeon: minimum surgical assistant services are identified by adding modifier 81 to the usual procedure number.
AG Primary physician
AQ Physician providing a service in an unlisted health professional shortage area (hpsa)
CC Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed)
CR Catastrophe/disaster related
GF Non-physician (e.g. nurse practitioner (np), certified registered nurse anesthetist (crna), certified registered nurse (crn), clinical nurse specialist (cns), physician assistant (pa)) services in a critical access hospital
GJ "opt out" physician or practitioner emergency or urgent service
GV Attending physician not employed or paid under arrangement by the patient's hospice provider
GW Service not related to the hospice patient's terminal condition
GZ Item or service expected to be denied as not reasonable and necessary
KX Requirements specified in the medical policy have been met
PD Diagnostic or related non diagnostic item or service provided in a wholly owned or operated entity to a patient who is admitted as an inpatient within 3 days
Q1 Routine clinical service provided in a clinical research study that is in an approved clinical research study
SG Ambulatory surgical center (asc) facility service
TG Complex/high tech level of care
X4 Episodic/focused services: for reporting services by clinicians who provide focused care on particular types of treatment limited to a defined period and circumstance; the patient has a problem, acute or chronic, that will be treated with surgery, radiation, or some other type of generally time-limited intervention; reporting clinician service examples include but are not limited to, the orthopedic surgeon performing a knee replacement and seeing the patient through the postoperative period
XS Separate structure, a service that is distinct because it was performed on a separate organ/structure
XU Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service
Date
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Notes
2013-01-01 Changed Medium Descriptor changed.
Pre-1990 Added Code added.
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