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CPT 27658: Tendon repairMedicare rate & RVUs

Reports secondary repair without a graft of an injured flexor tendon in the leg, with one code unit for each tendon repaired.

CMS RVU26DEffective Oct 1, 2026109 payment localities3K Medicare services in 2024

Medicare pays $357.06 for 27658 nationally in a facility.

Medicare rate · 27658

Tendon repair

Swap in your local Medicare rate.

Work RVUs
4.99
Total RVUs
10.69
Global days
090

National rate · 2026

$357.06

Facility setting, before claim adjustments.

See every locality for 27658 →

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 27658 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 27658 covers

This code describes secondary repair of a flexor tendon in the leg without a graft. It is used when the surgeon repairs a tendon after the primary repair period, such as for a delayed injury or a tendon requiring secondary reconstruction. An orthopedic or foot and ankle surgeon typically performs the operation in a hospital or ambulatory surgery center. The operative report should identify the tendon and explain the circumstances supporting secondary rather than primary repair.

Report one unit for each tendon repaired, and document that no graft was used. Medicare assigns a 90-day global period; the day-before preoperative visit and 90 days of related postoperative care are included. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and others at 50%. Modifier 50 is inappropriate for this descriptor or anatomy. Assistant-at-surgery payment may be made; co-surgeons require supporting documentation, and team-surgery payment 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 27658 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

27658 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$325.41
Alaska*Unavailable$439.72
ArizonaUnavailable$348.29
ArkansasUnavailable$321.48
AtlantaUnavailable$365.30
AustinUnavailable$364.07
BakersfieldUnavailable$366.14
Baltimore/Surr. CntysUnavailable$377.78
BeaumontUnavailable$340.40
BrazoriaUnavailable$351.32

27658 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
27658 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 27658 rate is calculated

Each of 27658’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 · 27658

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 4.99Practice expense 4.94Malpractice 0.76

10.6900 adjusted RVUs×$33.4009 conversion factor=$357.06

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

Payment rules and modifiers for 27658

27658 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 27658

Tendon 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)0The 150% bilateral adjustment doesn’t apply.
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 · 27658

Tendon 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 51 · payment effect

With and without the modifier

27658 without 51 · national facility

$357.06

Tendon repair

27658-51 · Second procedure: 50%

$178.53

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

27658 compared with similar codes

Compare codes

27658 vs 27656 vs 27659 vs 27665 vs 27654: national Medicare rates

Swap in your local Medicare rate.

  • 27658
    Tendon repair · 4.99 wRVU
    —
  • 27656
    Fascia repair · 4.59 wRVU
    $531.74
  • 27659
    Leg tendon repair · 6.92 wRVU
    —
  • 27665
    Tendon repair · 5.43 wRVU
    —
  • 27654
    Achilles repair · 10.27 wRVU
    —

How to choose

27656Fascia repair
Choose 27656 for primary repair of a leg flexor tendon without a graft; choose 27658 for secondary repair without a graft.
27659Leg tendon repair
Both describe secondary leg flexor tendon repair, but 27659 is used when a free graft is used.
27665Tendon repair
27665 is for secondary repair of a leg extensor tendon. Identify whether the repaired tendon is a flexor or extensor before selecting the code.
27654Achilles repair
27654 describes secondary repair of a ruptured Achilles tendon; 27658 is for a leg flexor tendon other than the Achilles.

Codes related to 27658

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

Codes related to 27658
CodeHow it relatesNational office range
Same family
27656Fascia repairPrimary repair of a leg flexor tendon without a graft.$471.37–$697.41
27659Leg tendon repairSecondary leg flexor tendon repair when a free graft is used.No office rate
Used instead
27664Tendon repairPrimary repair when the injured leg tendon is an extensor tendon.No office rate
27665Tendon repairSecondary repair when the injured leg tendon is an extensor tendon.No office rate
27654Achilles repairSecondary repair of a ruptured Achilles tendon.No office rate

27658 billing questions

How does this differ from 27656?

27658 is for secondary repair of a leg flexor tendon without a graft. 27656 is the primary-repair code for that tendon type.

When is 27659 more appropriate?

Use 27659 for secondary leg flexor tendon repair when a free graft is used. This code is for secondary repair without a graft.

Should modifier 50 be used for bilateral repairs?

No. CMS identifies bilateral adjustment as inappropriate for this descriptor or anatomy.

How many units should be reported when multiple tendons are repaired?

The code is reported for each tendon repaired. The operative documentation should identify each tendon treated.

What postoperative care is included?

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

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 27658PPRRVU2026_Oct_nonQPP.csv, line 2,997 (RVU26D)

Open CMS sourceHow we calculate rates

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