CPT 27486 · Other Procedure · Medicare (Novitas MAC)
Revision TKA — One Component at Medicare (Novitas MAC).
How Medicare (Novitas MAC) approaches CPT 27486 (Revision TKA — One Component) for prior-authorization review: at last review on 2026-05-09, the policy covers this code with prior authorization required.
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Criteria summary
High-level themes from the Medicare (Novitas MAC) policy of record for CPT 27486. Verbatim policy text and per-criterion analysis are available after sign-in.
- Imaging concordance documentation required.
- Prior diagnostic procedure documentation required.
Source: Novitas — 27486 revision TKA, governed by HOPD prior-authorization (no stand-alone LCD)
See the full Medicare (Novitas MAC) criteria.
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