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Billing code 27654: Achilles repairMedicare rate & RVUs

Reports operative reconstruction of an Achilles tendon when a secondary repair is needed, including procedures that use a graft to restore tendon continuity.

CMS RVU26DEffective Oct 1, 2026109 payment localities5.4K Medicare services in 2024

Medicare pays $676.03 for 27654 nationally in a facility.

Medicare rate · 27654

Achilles repair

Swap in your local Medicare rate.

Work RVUs
10.27
Total RVUs
20.24
Global days
090

National rate · 2026

$676.03

Facility setting, before claim adjustments.

See every locality for 27654 → · 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 27654 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 27654 covers

This code describes secondary surgery to restore continuity and function of the Achilles tendon, commonly after a rupture has not been repaired promptly or an earlier repair has failed. The surgeon exposes and prepares the tendon ends and may use a graft when needed to bridge or reinforce the defect. These procedures are typically performed by orthopedic or foot and ankle surgeons in an operating room.

Select this service when the operative report supports a secondary Achilles repair rather than primary repair of a rupture. Document the condition prompting secondary surgery, tendon findings, repair technique, and any graft use. CMS assigns a 90-day global period, including 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 others at 50%. For bilateral repair reported with modifier 50, payment is 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 27654 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

27654 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$617.69
Alaska*Unavailable$841.38
ArizonaUnavailable$659.60
ArkansasUnavailable$610.47
AtlantaUnavailable$692.40
AustinUnavailable$686.73
BakersfieldUnavailable$688.17
Baltimore/Surr. CntysUnavailable$714.71
BeaumontUnavailable$647.09
BrazoriaUnavailable$664.36

27654 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
27654 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 27654 rate is calculated

Each of 27654’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 · 27654

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 10.27Practice expense 8.35Malpractice 1.62

20.2400 adjusted RVUs×$33.4009 conversion factor=$676.03

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

Payment rules and modifiers for 27654

27654 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 27654

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 · 27654

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

27654 without 50 · national facility

$676.03

Achilles repair

27654-50 · Bilateral: 150%

$1,014.05

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

27654 compared with similar codes

Compare codes

27654 vs 27650 vs 27652 vs 27658 vs 27659: national Medicare rates

Swap in your local Medicare rate.

  • 27654
    Achilles repair · 10.27 wRVU
    —
  • 27650
    Achilles repair · 8.98 wRVU
    —
  • 27652
    Achilles repair · 10.51 wRVU
    —
  • 27658
    Tendon repair · 4.99 wRVU
    —
  • 27659
    Leg tendon repair · 6.92 wRVU
    —

How to choose

27650Achilles repair
27650 is for primary Achilles tendon repair. Choose 27654 when the operative circumstances call for secondary repair.
27652Achilles repair
27652 describes primary Achilles repair with graft. Graft use during a secondary Achilles repair is included in 27654.
27658Tendon repair
27658 applies to secondary repair of a lower-leg tendon other than the Achilles; 27654 is specific to the Achilles tendon.
27659Leg tendon repair
27659 is secondary repair with graft for a lower-leg tendon other than the Achilles. For secondary Achilles reconstruction, use 27654.

Codes related to 27654

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

Codes related to 27654
CodeHow it relatesNational office range
Same family
27650Achilles repairPrimary Achilles repair without the secondary-repair circumstance.No office rate
27652Achilles repairPrimary Achilles repair when a graft is used.No office rate
Used instead
27658Tendon repairSecondary repair for a lower-leg tendon other than the Achilles.No office rate
27659Leg tendon repairSecondary repair with graft for a lower-leg tendon other than the Achilles.No office rate

27654 billing questions

How does this differ from 27650?

Use 27654 for a secondary Achilles repair. Code 27650 describes primary repair, generally when the rupture is addressed as a primary repair rather than a secondary reconstruction.

When is 27652 more appropriate?

27652 is a primary Achilles repair that uses a graft. A graft used during a secondary Achilles repair remains within the scope of 27654.

Can graft procurement be billed separately?

Graft use, including obtaining the graft, is part of the secondary Achilles repair represented by 27654.

What postoperative care is included?

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

How should bilateral repairs be reported?

For bilateral Achilles repairs, report modifier 50; CMS pays the bilateral procedure at 150%.

Can an assistant or co-surgeon be reported?

Assistant-at-surgery services may be paid. Co-surgeons are paid only when supporting documentation is provided.

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 27654PPRRVU2026_Oct_nonQPP.csv, line 2,995 (RVU26D)

Open CMS sourceHow we calculate rates

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