CPT code 27690: Tendon transfer, single lower-leg tendon2026 Medicare rate & RVUs

Medicare pays $608.23 for 27690 nationally in a facility.

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

What 27690 covers

An orthopedic surgeon transfers or transplants one tendon in the lower-leg or ankle region, rerouting its attachment so it can perform a different function. A familiar example is transferring the posterior tibial tendon to help restore active foot lifting in a patient with foot drop. The service is generally performed in an operating room; the operative report should identify the donor tendon, its new attachment, and the functional problem being addressed.

Report this code for the transfer of one tendon, not for simply repairing a torn tendon, releasing adhesions, or lengthening a tendon. Document the tendon’s original and new course or attachment and the work performed. CMS assigns a 90-day global period, which includes 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. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be available; 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 27690 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

27690 rates by state

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

How the 27690 rate is calculated

Each of 27690’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.

Payment rules and modifiers for 27690

27690 has a 90-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 50

27690 compared with similar codes

How to choose

27691Tendon transferDeep, single tendon

27690 covers the first transferred tendon; 27691 is for each additional tendon transferred in the same operative service.

27685Tendon lengtheningSingle tendon, leg or ankle

Choose 27685 when the surgeon lengthens or shortens a tendon. Choose 27690 when one tendon is rerouted to assume a different function.

27680Tendon releaseSingle leg or ankle tendon

27680 addresses release of tendon adhesions. It does not describe transferring a tendon to a new attachment.

27658Tendon repairSecondary, no graft, each tendon

27658 describes repair of a leg tendon, whereas 27690 describes transferring one tendon to redirect its function.

Codes related to 27690

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

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

Open CMS sourceHow we calculate rates