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Billing code 27394: Tendon lengtheningMedicare rate & RVUs

Surgical lengthening of multiple thigh tendons, commonly hamstrings, is reported when several tendons are treated to improve a contracture or restricted motion.

CMS RVU26DEffective Oct 1, 2026109 payment localities1.3K Medicare services in 2024

Medicare pays $619.25 for 27394 nationally in a facility.

Medicare rate · 27394

Tendon lengthening

Swap in your local Medicare rate.

Work RVUs
8.57
Total RVUs
18.54
Global days
090

National rate · 2026

$619.25

Facility setting, before claim adjustments.

See every locality for 27394 → · 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.

On this page 10 sections
  1. Medicare rate
  2. What 27394 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 27394 covers

This operation lengthens multiple thigh tendons to reduce excessive tension and improve joint motion. It is commonly performed by an orthopedic surgeon, including a pediatric orthopedic surgeon, for conditions such as hamstring tightness associated with knee flexion contracture or spasticity. The procedure is generally performed in a hospital operating room or ambulatory surgery setting. The operative report should identify the tendons treated and the lengthening performed.

Select this code for multiple tendons; the single-tendon service is the key neighboring distinction. Document the clinical problem, treated tendons, side or sides, and operative work so the record supports the multiple-tendon service. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When other procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple-procedure reduction. Modifier 50 is inappropriate for this code. An assistant at surgery may be paid; co-surgeons and team surgery are 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 27394 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

27394 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$558.84
Alaska*Unavailable$752.78
ArizonaUnavailable$602.06
ArkansasUnavailable$551.39
AtlantaUnavailable$636.69
AustinUnavailable$628.68
BakersfieldUnavailable$627.06
Baltimore/Surr. CntysUnavailable$658.11
BeaumontUnavailable$590.44
BrazoriaUnavailable$605.72

27394 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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Local rates. Clear comparisons.

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View every state and territory as a table
27394 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 27394 rate is calculated

Each of 27394’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 · 27394

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 8.57Practice expense 8.15Malpractice 1.82

18.5400 adjusted RVUs×$33.4009 conversion factor=$619.25

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 27394

27394 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 27394

Tendon lengthening

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)0Not permitted.
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 · 27394

Tendon lengthening

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.

  • 24 Unrelated E/M visit by the same physician
  • 79 Unrelated procedure (starts its own global period)
  • 58 Staged, more extensive, or therapy procedure that was planned
  • 78 Unplanned 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

27394 without 51 · national facility

$619.25

Tendon lengthening

27394-51 · Second procedure: 50%

$309.63

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

27394 compared with similar codes

Compare codes

27394 vs 27393 vs 27395 vs 27396 vs 27397: national Medicare rates

Swap in your local Medicare rate.

  • 27394
    Tendon lengthening · 8.57 wRVU
    —
  • 27393
    Tendon lengthening · 6.43 wRVU
    —
  • 27395
    Tendon lengthening · 11.93 wRVU
    —
  • 27396
    Tendon transfer · 7.95 wRVU
    —
  • 27397
    Tendon transfer · 12.34 wRVU
    —

How to choose

27393Tendon lengthening
27393 is for lengthening a single thigh tendon. This code is for lengthening multiple tendons.
27395Tendon lengthening
Both are in the thigh-tendon lengthening code range, but the exact procedure and descriptor must support the selected code. Do not choose solely by the general term “lengthening.”
27396Tendon transfer
27396 describes tendon transfer or transplantation, which changes tendon routing or attachment; 27394 describes lengthening multiple tendons.
27397Tendon transfer
27397 describes transfer or transplantation of multiple tendons, not surgical lengthening of multiple tendons.

Codes related to 27394

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

Codes related to 27394
CodeHow it relatesNational office range
Same family
27393Tendon lengtheningSingle-tendon lengthening; 27394 represents treatment of multiple tendons.No office rate
27395Tendon lengtheningNearby thigh-tendon lengthening service; distinguish by the documented procedure and applicable descriptor.No office rate
Used instead
27396Tendon transferTendon transfer or transplantation rather than lengthening.No office rate
27397Tendon transferMultiple tendon transfers or transplantations rather than lengthening.No office rate

27394 billing questions

How does this code differ from 27393?

27393 describes lengthening a single thigh tendon. Use 27394 when multiple tendons are lengthened, with the operative report identifying the tendons treated.

What documentation supports reporting multiple tendon lengthening?

Document the contracture or motion problem, the tendons treated, and the lengthening work performed. The record should make clear that more than one tendon was treated.

Should modifier 50 be appended when both legs are treated?

No. CMS identifies bilateral adjustment as inapplicable to this code and modifier 50 as inappropriate.

What postoperative care is included?

The 90-day global period includes the day-before preoperative visit and related postoperative care during the 90 days after surgery.

Can an assistant or co-surgeon be reported?

An assistant at surgery may be paid. CMS does not permit co-surgeons or team surgery for this code.

How are other procedures in the same session paid?

Under the standard multiple-procedure rule, the highest-valued procedure is paid in full and other procedures are subject to a 50% reduction.

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 27394PPRRVU2026_Oct_nonQPP.csv, line 2,870 (RVU26D)

Open CMS sourceHow we calculate rates

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