FeeBase
Log inGet started
Menu

CPT code 27659: Leg tendon repair, secondary repair with free graft2026 Medicare rate & RVUs

Report this service for secondary reconstruction of a disrupted lower-leg tendon when a free tendon graft is used to restore continuity.

CMS RVU26DEffective Oct 1, 2026109 payment localities2.4K Medicare services in 2024

Medicare pays $446.57 for 27659 nationally in a facility.

Medicare rate · 27659

Leg tendon repair, secondary repair with free graft

Office or facility?

Work RVUs
6.92
Total RVUs
13.37
Global days
090

National rate · 2026

$446.57

Facility setting, before claim adjustments.

See every locality for 27659 →Billed by an NP, PA or therapist? →

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

Your location

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What 27659 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 27659 covers

An orthopedic or foot-and-ankle surgeon uses this service to reconstruct a disrupted tendon in the leg when a secondary repair requires a free graft. It applies to repair of a lower-leg tendon other than the Achilles tendon, which has its own code family. The graft bridges or reinforces the tendon defect as part of restoring tendon continuity, typically during an operative repair in a hospital or ambulatory surgery center.

Report one unit for each tendon repaired, and document the tendon, the disruption, the secondary nature of the repair, and use of a free graft. This major surgery has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate for this code. Assistant-at-surgery services may be paid; co-surgeons require 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 27659 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

27659 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$409.42
AlaskaUnavailable$559.14
ArizonaUnavailable$436.15
ArkansasUnavailable$404.82
Atlanta, GAUnavailable$456.83
Austin, TXUnavailable$453.84
Bakersfield, CAUnavailable$455.54
Baltimore area, MDUnavailable$471.42
Beaumont, TXUnavailable$427.81
Brazoria, TXUnavailable$439.50

27659 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

View every state and territory as a table
27659 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 27659 rate is calculated

Each of 27659’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 · 27659

RVUs × geographic indexes × conversion factor

Office or facility?

Work6.92

6.92 RVUs× 1.000 GPCI

Practice expense5.46

5.46 RVUs× 1.000 GPCI

Malpractice0.99

0.99 RVUs× 1.000 GPCI

Adjusted RVUs

13.3700

Conversion factor

$33.4009

Medicare rate

$446.57

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 27659

27659 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 27659

Leg tendon repair, secondary repair with free graft

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)2Paid.
Co-surgeons (62)1Permitted with supporting documentation.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.69/0.21Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 27659

Leg tendon repair, secondary repair with free graft

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.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

27659 without 51 · national facility

$446.57

Leg tendon repair, secondary repair with free graft

27659-51 · Second procedure: 50%

$223.29

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%).

When to use modifier 51

27659 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 27659

    Leg tendon repair, secondary repair with free graft6.92 wRVU

    Not priced

  • 27658

    Tendon repair, secondary, no graft, each tendon4.99 wRVU

    Not priced

  • 27654

    Achilles repair, secondary repair10.27 wRVU

    Not priced

  • 27665

    Tendon repair, secondary extensor, each tendon5.43 wRVU

    Not priced

How to choose

27658Tendon repairSecondary, no graft, each tendon
Both represent secondary repair of a disrupted leg tendon. Choose 27659 when a free graft is used; 27658 is the counterpart without a free graft.
27654Achilles repairSecondary repair
27654 is specific to secondary repair of the Achilles tendon. Use 27659 for a qualifying disrupted leg tendon other than the Achilles.
27665Tendon repairSecondary extensor, each tendon
27665 describes primary repair of a leg extensor tendon with a free graft. 27659 is for secondary repair of a disrupted leg tendon.

Codes related to 27659

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 27659
CodeHow it relatesNational office range
Same family
27658Tendon repair, secondary, no graft, each tendonSecondary repair of a disrupted leg tendon without a free graft.No office rate
Used instead
27654Achilles repair, secondary repairUse the Achilles-specific code for secondary repair of the Achilles tendon.No office rate
27664Tendon repair, primary extensor, no graftPrimary repair of a leg extensor tendon without a free graft.No office rate
27665Tendon repair, secondary extensor, each tendonPrimary repair of a leg extensor tendon using a free graft.No office rate
27652Achilles repair, primary repair with graftPrimary Achilles tendon repair with graft, rather than secondary repair of another leg tendon.No office rate

27659 billing questions

How does this differ from 27658?

27659 is for secondary repair of a disrupted leg tendon using a free graft. 27658 describes the corresponding secondary repair without a free graft.

Can this code be used for a secondary Achilles repair?

No. Achilles tendon repairs are represented by the Achilles-specific codes, including 27654 for secondary repair. Use 27659 for a qualifying non-Achilles leg tendon.

How many units should be reported?

The code is reported for each tendon repaired. Document the specific tendon treated and the graft used for each repair.

Should modifier 50 be appended for repairs on both sides?

No. The CMS bilateral adjustment does not apply, and modifier 50 is inappropriate for this code.

What assistant or co-surgeon billing rules apply?

Assistant-at-surgery services may be paid. Co-surgeon payment requires supporting documentation; team surgery is not permitted.

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
RVUs for 27659PPRRVU2026_Oct_nonQPP.csv, line 2,998 (RVU26D)

Open CMS sourceHow we calculate rates

Did this answer your question about what 27659 pays?

Tell us what you were actually trying to work out. We’ll answer you directly, or build the page that does.

Fee sheets · Coming soon

Put 27659 and the rest of your codes on one sheet

Your codes at your locality, with payer contracts beside Medicare.

Join the waitlist