CPT
23472 — Arthroplasty, glenohumeral joint; total shoulder
Verify the code matches the actual service and dose.
Surgery & procedures
27486 — Revision of total knee arthroplasty, one component
This code covers a revision total knee replacement surgery — the surgical removal and replacement of a failed or worn knee implant component.
- Typical setting: Hospital OR, ASC
- National avg charge (illustrative): $2,800-$5,500 Medicare allowed for surgeon professional fee (total hospital charges: $40,000-$80,000+)
- Most-disputed reason: Billing 27486 vs. 27487: 27486 covers revision of one component while 27487 covers all components — billing 27486 when all components were replaced underbills the procedure
What it means
What 27486 actually means
This code covers a revision total knee replacement surgery — the surgical removal and replacement of a failed or worn knee implant component. Revision surgery is significantly more complex than primary knee replacement (27447) because it involves removing a previously implanted prosthesis and dealing with bone loss or deformity. It has a 90-day global period.
Common errors with this code
What goes wrong on real bills.
Most bills that look correct still contain at least one of these issues. Up to 49% of medical bills contain errors (CFPB).
- Billing 27486 vs. 27487: 27486 covers revision of one component while 27487 covers all components — billing 27486 when all components were replaced underbills the procedure
- Implant billing fraud: facility and physician bills should not both include implant costs — verify with the Explanation of Benefits
- Upcoding from primary total knee (27447): billing a revision code for what was actually a primary total knee replacement without documented prior implant failure
If you see 27486 on your bill
Three steps before paying.
1. Get the itemized bill. If your statement only shows a summary, request the CPT-level itemized bill before paying. Generate the request language →
2. Cross-check against the EOB. Compare what your insurer's Explanation of Benefits says you owe versus what the hospital is asking. They disagree more often than people think. Read the bill-vs-EOB guide →
3. Run a free Bill Scan. Upload the bill (and EOB if you have it) and BillBusted will flag the most likely issues with this specific code in your specific state. Run free scan →
Related codes
Other codes in this category.
People who land on 27486 often also see these adjacent codes on the same bill.
CPT
27130 — Total hip replacement (arthroplasty)
Same scrutiny as knee replacement — verify all providers in-network.
CPT
27447 — Total knee replacement (arthroplasty)
Big-ticket surgery — verify all providers were in-network.
CPT
29881 — Arthroscopy, knee, surgical; with meniscectomy
Verify the code matches the actual service and dose.
CPT
29888 — Arthroscopy, knee, surgical; with ACL repair/augmentation or reconstruction
Verify the code matches the actual service and dose.
Related BillBusted guides
Plain-English reads if you see 27486 on a bill.
27486 FAQ
Plain-English answers.
What does 27486 usually cost?
$2,800-$5,500 Medicare allowed for surgeon professional fee (total hospital charges: $40,000-$80,000+). Costs vary by region, payer contract, and whether the service was performed in a hospital outpatient department (which adds a facility fee) versus a free-standing clinic.
What's the most common billing error on 27486?
Billing 27486 vs. 27487: 27486 covers revision of one component while 27487 covers all components — billing 27486 when all components were replaced underbills the procedure
What should I do if I see 27486 on my bill?
Request the itemized bill and the matching EOB from your insurer. Compare the units/quantity billed against what you actually received. Run a free BillBusted scan to flag the most likely errors specific to 27486 before paying.
Don't pay 27486 blindly.
The free scan tells you in under 60 seconds whether this charge looks reasonable for your situation.