CPT code 27681: Tenolysis, multiple tendons2026 Medicare rate & RVUs in Texas
Surgical release of adhesions involving multiple lower-leg or ankle tendons, reported when tethering limits tendon glide and motion.
CMS doesn’t publish an office rate for 27681 in Texas.
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 27681 covers
Tenolysis frees flexor or extensor tendons in the lower leg or ankle from adhesions that restrict their movement. A typical situation is persistent tendon tethering after a prior tendon repair, fracture, or ankle operation, with impaired excursion despite appropriate recovery or therapy. An orthopedic surgeon, often a foot-and-ankle specialist, performs the release in an operating room.
Report this code when the operation releases multiple tendons; use the single-tendon sibling when only one tendon is released. The operative report should identify the tendons, side, adhesions, and work performed to restore tendon glide. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment is restricted; 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 27681 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin, TX | Unavailable | $498.08 |
| Beaumont, TX | Unavailable | $467.03 |
| Brazoria, TX | Unavailable | $480.41 |
| Dallas, TX | Unavailable | $484.97 |
| Fort Worth, TX | Unavailable | $483.32 |
| Galveston, TX | Unavailable | $482.84 |
| Houston, TX | Unavailable | $505.53 |
| Rest of Texas | Unavailable | $474.48 |
How the 27681 rate is calculated
Each of 27681’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 · 27681
RVUs × geographic indexes × conversion factor
Work6.87
6.87 RVUs× 1.000 GPCI
Practice expense6.55
6.55 RVUs× 1.000 GPCI
Malpractice1.24
1.24 RVUs× 1.000 GPCI
Adjusted RVUs
14.6600
Conversion factor
$33.4009
Medicare rate
$489.66
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 27681
27681 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 27681
Tenolysis, multiple tendons
| 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) | 1 | Not paid (statutory restriction). |
| 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 · 27681
Tenolysis, multiple tendons
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
27681 without 50 · national facility
$489.66
Tenolysis, multiple tendons
27681-50 · Bilateral: 150%
$734.49
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).
27681 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 27680Tendon releaseSingle leg or ankle tendon
- 27680 is for release of one tendon. Choose 27681 when multiple lower-leg or ankle tendons are released from adhesions.
- 27685Tendon lengtheningSingle tendon, leg or ankle
- 27685 describes lengthening or shortening a single tendon to address tendon tightness or length. Tenolysis instead frees adhesions restricting tendon glide.
- 27686Tendon adjustmentMultiple tendons, same incision
- 27686 addresses lengthening or shortening multiple tendons. Report 27681 when the operative work is releasing adhesions from multiple tendons.
- 27690Tendon transferSingle lower-leg tendon
- 27690 involves tendon transfer or rerouting. It is distinct from freeing multiple tendons from adhesions without transferring them.
27681 billing questions
When should I report 27681 rather than 27680?
Use 27681 when the surgeon releases multiple lower-leg or ankle tendons from adhesions. Use 27680 when the release involves one tendon.
Should I report a separate unit for each tendon released?
This code describes release involving multiple tendons, so do not repeat the single-tendon code solely to count each tendon. Document the tendons treated and the release performed.
What documentation supports the multiple-tendon code?
The operative report should identify the affected tendons and side, describe adhesions that restricted glide, and explain the release performed on the multiple tendons.
How does the 90-day global period affect postoperative billing?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
How is bilateral tenolysis handled?
For a bilateral procedure, modifier 50 is paid at 150%. The standard multiple-procedure reduction also applies when procedures are performed in the same session.
Can an assistant or co-surgeon be billed for this operation?
Assistant-at-surgery payment is subject to a statutory restriction. 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
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