CPT code 27658: Tendon repair, secondary, no graft, each tendon2026 Medicare rate & RVUs in California
Reports secondary repair without a graft of an injured flexor tendon in the leg, with one code unit for each tendon repaired.
CMS doesn’t publish an office rate for 27658 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 27658 covers
This code describes secondary repair of a flexor tendon in the leg without a graft. It is used when the surgeon repairs a tendon after the primary repair period, such as for a delayed injury or a tendon requiring secondary reconstruction. An orthopedic or foot and ankle surgeon typically performs the operation in a hospital or ambulatory surgery center. The operative report should identify the tendon and explain the circumstances supporting secondary rather than primary repair.
Report one unit for each tendon repaired, and document that no graft was used. Medicare assigns a 90-day global period; the day-before preoperative visit and 90 days of related postoperative care are included. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and others at 50%. Modifier 50 is inappropriate for this descriptor or anatomy. Assistant-at-surgery payment may be made; co-surgeons require supporting documentation, and team-surgery payment 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 27658 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 | $366.14 |
| Chico, CA | Unavailable | $363.95 |
| El Centro, CA | Unavailable | $364.08 |
| Fresno, CA | Unavailable | $363.95 |
| Hanford, CA | Unavailable | $363.95 |
| Los Angeles, CA | Unavailable | $385.55 |
| Madera, CA | Unavailable | $363.95 |
| Marin County, CA | Unavailable | $426.81 |
| Merced, CA | Unavailable | $363.95 |
| Modesto, CA | Unavailable | $363.95 |
| Napa, CA | Unavailable | $407.54 |
| Oxnard, CA | Unavailable | $382.18 |
| Redding, CA | Unavailable | $363.95 |
| Rest of California | Unavailable | $363.95 |
| Riverside, CA | Unavailable | $372.16 |
| Sacramento, CA | Unavailable | $378.17 |
| Salinas, CA | Unavailable | $376.68 |
| San Benito County, CA | Unavailable | $436.54 |
| San Diego, CA | Unavailable | $382.77 |
| San Francisco, CA | Unavailable | $425.94 |
| San Luis Obispo, CA | Unavailable | $371.05 |
| Santa Clara County, CA | Unavailable | $433.01 |
| Santa Cruz, CA | Unavailable | $384.25 |
| Santa Maria, CA | Unavailable | $377.33 |
| Santa Rosa, CA | Unavailable | $387.90 |
| Stockton, CA | Unavailable | $363.95 |
| Vallejo, CA | Unavailable | $406.29 |
| Visalia, CA | Unavailable | $363.95 |
| Yuba City, CA | Unavailable | $363.95 |
How the 27658 rate is calculated
Each of 27658’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 · 27658
RVUs × geographic indexes × conversion factor
Work4.99
4.99 RVUs× 1.000 GPCI
Practice expense4.94
4.94 RVUs× 1.000 GPCI
Malpractice0.76
0.76 RVUs× 1.000 GPCI
Adjusted RVUs
10.6900
Conversion factor
$33.4009
Medicare rate
$357.06
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 27658
27658 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 27658
Tendon repair, secondary, no graft, each tendon
| 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) | 0 | The 150% bilateral adjustment doesn’t apply. |
| 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 · 27658
Tendon repair, secondary, no graft, each tendon
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 51 · payment effect
With and without the modifier
27658 without 51 · national facility
$357.06
Tendon repair, secondary, no graft, each tendon
27658-51 · Second procedure: 50%
$178.53
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
27658 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 27656Fascia repairLower leg
- Choose 27656 for primary repair of a leg flexor tendon without a graft; choose 27658 for secondary repair without a graft.
- 27659Leg tendon repairSecondary repair with free graft
- Both describe secondary leg flexor tendon repair, but 27659 is used when a free graft is used.
- 27665Tendon repairSecondary extensor, each tendon
- 27665 is for secondary repair of a leg extensor tendon. Identify whether the repaired tendon is a flexor or extensor before selecting the code.
- 27654Achilles repairSecondary repair
- 27654 describes secondary repair of a ruptured Achilles tendon; 27658 is for a leg flexor tendon other than the Achilles.
27658 billing questions
How does this differ from 27656?
27658 is for secondary repair of a leg flexor tendon without a graft. 27656 is the primary-repair code for that tendon type.
When is 27659 more appropriate?
Use 27659 for secondary leg flexor tendon repair when a free graft is used. This code is for secondary repair without a graft.
Should modifier 50 be used for bilateral repairs?
No. CMS identifies bilateral adjustment as inappropriate for this descriptor or anatomy.
How many units should be reported when multiple tendons are repaired?
The code is reported for each tendon repaired. The operative documentation should identify each tendon treated.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
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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