CPT code 27686: Tendon adjustment, multiple tendons, same incision2026 Medicare rate & RVUs in California
Reports operative lengthening or shortening of multiple leg or ankle tendons through one incision to address contracture, imbalance, or restricted motion.
CMS doesn’t publish an office rate for 27686 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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On this page 9 sections
What 27686 covers
This code describes surgically changing the length of more than one tendon in the leg or ankle through the same incision. An orthopedic foot-and-ankle surgeon or podiatric surgeon may perform the procedure to address tendon contracture or imbalance that limits motion or alters foot and ankle position. The operative report should identify the tendons treated, the lengthening or shortening performed, and the shared incision approach.
Report this code for the multiple-tendon procedure through one incision, rather than reporting the single-tendon service for each tendon treated through that incision. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple-procedure reduction. For a bilateral procedure reported with modifier 50, CMS pays at 150%. Assistant-at-surgery payment is restricted; 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 27686 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 | $512.02 |
| Chico, CA | Unavailable | $508.54 |
| El Centro, CA | Unavailable | $508.74 |
| Fresno, CA | Unavailable | $508.54 |
| Hanford, CA | Unavailable | $508.54 |
| Los Angeles, CA | Unavailable | $538.06 |
| Madera, CA | Unavailable | $508.54 |
| Marin County, CA | Unavailable | $590.96 |
| Merced, CA | Unavailable | $508.54 |
| Modesto, CA | Unavailable | $508.54 |
| Napa, CA | Unavailable | $565.58 |
| Oxnard, CA | Unavailable | $532.90 |
| Redding, CA | Unavailable | $508.54 |
| Rest of California | Unavailable | $508.54 |
| Riverside, CA | Unavailable | $521.71 |
| Sacramento, CA | Unavailable | $527.39 |
| Salinas, CA | Unavailable | $525.29 |
| San Benito County, CA | Unavailable | $604.60 |
| San Diego, CA | Unavailable | $533.04 |
| San Francisco, CA | Unavailable | $589.58 |
| San Luis Obispo, CA | Unavailable | $517.56 |
| Santa Clara County, CA | Unavailable | $598.93 |
| Santa Cruz, CA | Unavailable | $534.51 |
| Santa Maria, CA | Unavailable | $526.00 |
| Santa Rosa, CA | Unavailable | $539.51 |
| Stockton, CA | Unavailable | $508.54 |
| Vallejo, CA | Unavailable | $563.58 |
| Visalia, CA | Unavailable | $508.54 |
| Yuba City, CA | Unavailable | $508.54 |
How the 27686 rate is calculated
Each of 27686’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 · 27686
RVUs × geographic indexes × conversion factor
Work7.56
7.56 RVUs× 1.000 GPCI
Practice expense6.28
6.28 RVUs× 1.000 GPCI
Malpractice1.22
1.22 RVUs× 1.000 GPCI
Adjusted RVUs
15.0600
Conversion factor
$33.4009
Medicare rate
$503.02
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 27686
27686 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 27686
Tendon adjustment, multiple tendons, same incision
| 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 · 27686
Tendon adjustment, multiple tendons, same incision
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
27686 without 50 · national facility
$503.02
Tendon adjustment, multiple tendons, same incision
27686-50 · Bilateral: 150%
$754.53
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).
27686 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 27685Tendon lengtheningSingle tendon, leg or ankle
- Choose 27685 for lengthening or shortening one tendon. Choose 27686 for multiple tendons treated through the same incision.
- 27687Calf tendon revisionGastrocnemius recession
- 27687 describes a calf tendon recession. This code is for lengthening or shortening multiple leg or ankle tendons through one incision.
- 27680Tendon releaseSingle leg or ankle tendon
- 27680 addresses tendon release or tenolysis. This code applies when the surgeon surgically changes the length of multiple tendons.
- 27690Tendon transferSingle lower-leg tendon
- 27690 describes transfer of a tendon to a different position. This code describes lengthening or shortening multiple tendons without that transfer.
27686 billing questions
When should this be selected instead of 27685?
Use 27686 when multiple tendons are lengthened or shortened through the same incision. Code 27685 describes the single-tendon service.
Is the code reported once for each tendon?
No. For multiple tendons treated through the same incision, report this multiple-tendon code rather than multiplying it by the number of tendons.
What documentation supports reporting this code?
Document each tendon treated, whether it was lengthened or shortened, and that the tendons were addressed through the same incision.
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 are bilateral and same-session procedures handled?
A bilateral procedure reported with modifier 50 is paid at 150%. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others are reduced.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment is restricted. Co-surgeon payment requires 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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