CPT code 27691: Tendon transfer, deep, single tendon2026 Medicare rate & RVUs in California

CMS doesn’t publish an office rate for 27691 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.

What 27691 covers

An orthopedic surgeon mobilizes a deep tendon and redirects it to a different attachment to change the pull on the foot or ankle. A posterior tibial tendon transfer to help address foot drop is a typical example; deep tendon transfer may also be part of reconstructive surgery for tendon imbalance. These procedures are generally performed in an operating room, commonly in a hospital or ambulatory surgery setting.

Report this code for one deep lower-leg tendon transferred or rerouted, rather than a tendon that is simply repaired or lengthened. The operative report should identify the tendon, its original and new attachment, and the reason for the transfer. An additional tendon may be reported with the applicable add-on code. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care. When multiple procedures occur in one session, the highest-valued is paid in full and others at 50%; bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be made; 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 27691 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

How the 27691 rate is calculated

Each of 27691’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 27691

27691 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

27691 compared with similar codes

How to choose

27690Tendon transferSingle lower-leg tendon

Choose 27691 for a deep tendon transfer and 27690 for a superficial tendon transfer. The operative report should establish which tendon was rerouted.

27692Tendon transferEach additional tendon

27692 represents an additional tendon in a transfer procedure; it is not the primary code for the first tendon.

27685Tendon lengtheningSingle tendon, leg or ankle

27685 is used for tendon lengthening. Use 27691 when the tendon is redirected to a different attachment rather than lengthened.

27658Tendon repairSecondary, no graft, each tendon

27658 addresses tendon repair. A transfer to a new attachment is the distinguishing service for 27691.

Codes related to 27691

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