CPT code 27650: Achilles repair, primary rupture repair2026 Medicare rate & RVUs in California
Reports primary surgical repair of a ruptured Achilles tendon, such as direct repair of a complete rupture by an orthopedic surgeon or podiatrist.
CMS doesn’t publish an office rate for 27650 in California.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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What 27650 covers
This service repairs a ruptured Achilles tendon by bringing the tendon ends together, using an open or percutaneous approach. Orthopedic surgeons and podiatrists commonly perform it in an operating room for a complete rupture when primary repair is selected. The operative report should identify the Achilles tendon and describe the rupture and repair performed.
Select this code for primary repair, not a secondary repair or a primary repair that uses a graft. The documented procedure should distinguish it from the graft repair and secondary repair codes. CMS assigns a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. When performed bilaterally with modifier 50, CMS pays at 150%. Assistant-at-surgery services may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
Where 27650 pays more and less in California
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
29 of 29 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Bakersfield, CA | Unavailable | $637.51 |
| Chico, CA | Unavailable | $633.38 |
| El Centro, CA | Unavailable | $633.62 |
| Fresno, CA | Unavailable | $633.38 |
| Hanford, CA | Unavailable | $633.38 |
| Los Angeles, CA | Unavailable | $670.78 |
| Madera, CA | Unavailable | $633.38 |
| Marin County, CA | Unavailable | $739.67 |
| Merced, CA | Unavailable | $633.38 |
| Modesto, CA | Unavailable | $633.38 |
| Napa, CA | Unavailable | $707.06 |
| Oxnard, CA | Unavailable | $664.61 |
| Redding, CA | Unavailable | $633.38 |
| Rest of California | Unavailable | $633.38 |
| Riverside, CA | Unavailable | $649.03 |
| Sacramento, CA | Unavailable | $657.56 |
| Salinas, CA | Unavailable | $654.96 |
| San Benito County, CA | Unavailable | $756.73 |
| San Diego, CA | Unavailable | $665.15 |
| San Francisco, CA | Unavailable | $738.02 |
| San Luis Obispo, CA | Unavailable | $645.24 |
| Santa Clara County, CA | Unavailable | $750.00 |
| Santa Cruz, CA | Unavailable | $667.41 |
| Santa Maria, CA | Unavailable | $655.99 |
| Santa Rosa, CA | Unavailable | $673.69 |
| Stockton, CA | Unavailable | $633.38 |
| Vallejo, CA | Unavailable | $704.69 |
| Visalia, CA | Unavailable | $633.38 |
| Yuba City, CA | Unavailable | $633.38 |
How the 27650 rate is calculated
Each of 27650’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 27650
RVUs × geographic indexes × conversion factor
Work8.98
8.98 RVUs× 1.000 GPCI
Practice expense8.26
8.26 RVUs× 1.000 GPCI
Malpractice1.45
1.45 RVUs× 1.000 GPCI
Adjusted RVUs
18.6900
Conversion factor
$33.4009
Medicare rate
$624.26
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 27650
27650 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 27650
Achilles repair, primary rupture repair
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.69/0.21 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 27650
Achilles repair, primary rupture repair
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
27650 without 50 · national facility
$624.26
Achilles repair, primary rupture repair
27650-50 · Bilateral: 150%
$936.39
Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).
27650 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 27652Achilles repairPrimary repair with graft
- Both are primary repairs of a ruptured Achilles tendon. Choose 27652 when the primary repair includes a graft; 27650 represents repair without a graft.
- 27654Achilles repairSecondary repair
- 27654 is for secondary Achilles repair, with or without a graft. 27650 is for primary repair.
- 27658Tendon repairSecondary, no graft, each tendon
- 27658 concerns primary repair of a leg extensor tendon, not the Achilles tendon. Use 27650 when the repaired structure is the Achilles.
27650 billing questions
How does this differ from 27652?
27650 is for primary Achilles repair without a graft. Use 27652 when the primary repair includes a graft.
When is 27654 more appropriate?
27654 describes secondary Achilles repair, with or without a graft. Choose based on the documented repair type rather than treating all Achilles repairs as primary.
Can 27650 and 27652 be reported for the same tendon?
They represent different primary repair approaches. Select the code supported by the operative report rather than reporting both for one repair.
What does the 90-day global period include?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
How is bilateral Achilles repair handled?
CMS lists bilateral reporting with modifier 50 and payment at 150%. The operative documentation should support repair on both sides.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery services may be paid. Co-surgeons are paid only with supporting documentation; team surgery is not permitted.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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