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Billing code 27650: Achilles repairMedicare rate & RVUs

Reports primary surgical repair of a ruptured Achilles tendon, such as direct repair of a complete rupture by an orthopedic surgeon or podiatrist.

CMS RVU26DEffective Oct 1, 2026109 payment localities3.7K Medicare services in 2024

Medicare pays $624.26 for 27650 nationally in a facility.

Medicare rate · 27650

Achilles repair

Swap in your local Medicare rate.

Work RVUs
8.98
Total RVUs
18.69
Global days
090

National rate · 2026

$624.26

Facility setting, before claim adjustments.

See every locality for 27650 → · 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 27650 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 27650 covers

This service repairs a ruptured Achilles tendon by bringing the tendon ends together, using an open or percutaneous approach. Orthopedic surgeons and podiatrists commonly perform it in an operating room for a complete rupture when primary repair is selected. The operative report should identify the Achilles tendon and describe the rupture and repair performed.

Select this code for primary repair, not a secondary repair or a primary repair that uses a graft. The documented procedure should distinguish it from the graft repair and secondary repair codes. CMS assigns a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. When performed bilaterally with modifier 50, CMS pays at 150%. Assistant-at-surgery services may be paid; 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 27650 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

27650 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$568.76
Alaska*Unavailable$770.42
ArizonaUnavailable$608.74
ArkansasUnavailable$561.87
AtlantaUnavailable$639.31
AustinUnavailable$635.34
BakersfieldUnavailable$637.51
Baltimore/Surr. CntysUnavailable$660.68
BeaumontUnavailable$595.99
BrazoriaUnavailable$613.52

27650 rates by state

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

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Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

View every state and territory as a table
27650 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 27650 rate is calculated

Each of 27650’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 · 27650

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 8.98Practice expense 8.26Malpractice 1.45

18.6900 adjusted RVUs×$33.4009 conversion factor=$624.26

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

Payment rules and modifiers for 27650

27650 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 27650

Achilles repair

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)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
Assistant at surgery (80/81/82/AS)2Paid.
Co-surgeons (62)1Permitted with supporting documentation.
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 · 27650

Achilles repair

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 50 · payment effect

With and without the modifier

27650 without 50 · national facility

$624.26

Achilles repair

27650-50 · Bilateral: 150%

$936.39

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).

When to use modifier 50

27650 compared with similar codes

Compare codes

27650 vs 27652 vs 27654 vs 27658: national Medicare rates

Swap in your local Medicare rate.

  • 27650
    Achilles repair · 8.98 wRVU
    —
  • 27652
    Achilles repair · 10.51 wRVU
    —
  • 27654
    Achilles repair · 10.27 wRVU
    —
  • 27658
    Tendon repair · 4.99 wRVU
    —

How to choose

27652Achilles repair
Both are primary repairs of a ruptured Achilles tendon. Choose 27652 when the primary repair includes a graft; 27650 represents repair without a graft.
27654Achilles repair
27654 is for secondary Achilles repair, with or without a graft. 27650 is for primary repair.
27658Tendon repair
27658 concerns primary repair of a leg extensor tendon, not the Achilles tendon. Use 27650 when the repaired structure is the Achilles.

Codes related to 27650

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

Codes related to 27650
CodeHow it relatesNational office range
Same family
27652Achilles repairPrimary Achilles rupture repair when a graft is used.No office rate
27654Achilles repairSecondary Achilles repair, with or without a graft.No office rate
Used instead
27658Tendon repairA primary repair code for an extensor tendon of the leg, rather than the Achilles.No office rate

27650 billing questions

How does this differ from 27652?

27650 is for primary Achilles repair without a graft. Use 27652 when the primary repair includes a graft.

When is 27654 more appropriate?

27654 describes secondary Achilles repair, with or without a graft. Choose based on the documented repair type rather than treating all Achilles repairs as primary.

Can 27650 and 27652 be reported for the same tendon?

They represent different primary repair approaches. Select the code supported by the operative report rather than reporting both for one repair.

What does the 90-day global period include?

The day-before preoperative visit and 90 days of related postoperative care are included in the global period.

How is bilateral Achilles repair handled?

CMS lists bilateral reporting with modifier 50 and payment at 150%. The operative documentation should support repair on both sides.

Can an assistant or co-surgeon be reported?

Assistant-at-surgery services may be paid. 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

Show the CMS file lines behind this rate
RVUs for 27650PPRRVU2026_Oct_nonQPP.csv, line 2,993 (RVU26D)

Open CMS sourceHow we calculate rates

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