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Billing code 27665: Tendon repairMedicare rate & RVUs

Reports secondary repair of an extensor tendon in the lower leg, with or without a graft, for each tendon treated.

CMS RVU26DEffective Oct 1, 2026109 payment localities610 Medicare services in 2024

Medicare pays $399.47 for 27665 nationally in a facility.

Medicare rate · 27665

Tendon repair

Swap in your local Medicare rate.

Work RVUs
5.43
Total RVUs
11.96
Global days
090

National rate · 2026

$399.47

Facility setting, before claim adjustments.

See every locality for 27665 → · 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 27665 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 27665 covers

This code describes secondary repair of an extensor tendon in the lower leg, performed without a graft or with graft material when needed. It may be used for delayed or previously treated tendon injuries when the surgeon repairs an extensor tendon such as the tibialis anterior or a toe extensor. Orthopedic surgeons and foot and ankle surgeons typically perform the procedure in an operating room, often for chronic tendon disruption or a failed prior repair.

Report one unit for each tendon repaired, and document the specific tendon, the injury or prior repair, the secondary nature of the procedure, and whether graft material was used. Code 27664 is the primary-repair counterpart; code 27665 is not the code for a primary repair. 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 other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment may be available; 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 27665 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

27665 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$363.23
Alaska*Unavailable$489.40
ArizonaUnavailable$389.43
ArkansasUnavailable$358.73
AtlantaUnavailable$408.88
AustinUnavailable$407.49
BakersfieldUnavailable$409.71
Baltimore/Surr. CntysUnavailable$423.06
BeaumontUnavailable$380.40
BrazoriaUnavailable$392.83

27665 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
27665 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 27665 rate is calculated

Each of 27665’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 · 27665

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 5.43Practice expense 5.66Malpractice 0.87

11.9600 adjusted RVUs×$33.4009 conversion factor=$399.47

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

Payment rules and modifiers for 27665

27665 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 27665

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 · 27665

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

27665 without 51 · national facility

$399.47

Tendon repair

27665-51 · Second procedure: 50%

$199.74

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

27665 compared with similar codes

Compare codes

27665 vs 27664 vs 27659 vs 27654: national Medicare rates

Swap in your local Medicare rate.

  • 27665
    Tendon repair · 5.43 wRVU
    —
  • 27664
    Tendon repair · 4.61 wRVU
    —
  • 27659
    Leg tendon repair · 6.92 wRVU
    —
  • 27654
    Achilles repair · 10.27 wRVU
    —

How to choose

27664Tendon repair
Both address lower-leg extensor tendon repair, but 27664 is for primary repair without graft. Use 27665 for secondary repair, with or without graft.
27659Leg tendon repair
27659 is for secondary repair of a flexor tendon. Choose 27665 when the repaired tendon is an extensor tendon.
27654Achilles repair
27654 is a secondary repair code specific to the Achilles tendon. Use 27665 for secondary repair of another lower-leg extensor tendon.

Codes related to 27665

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

Codes related to 27665
CodeHow it relatesNational office range
Same family
27664Tendon repairPrimary repair counterpart for a lower-leg extensor tendon, without graft.No office rate
27659Leg tendon repairSecondary repair counterpart for a lower-leg flexor tendon.No office rate
27658Tendon repairPrimary repair counterpart for a lower-leg flexor tendon, without graft.No office rate
Used instead
27690Tendon transferTendon transfer may be selected when reconstruction uses tendon transfer rather than direct repair.No office rate

27665 billing questions

How does 27665 differ from 27664?

27665 is for secondary repair of a lower-leg extensor tendon, with or without graft. Use 27664 for primary repair without graft.

Can 27665 be reported for a flexor tendon?

No. It applies to extensor tendons; codes 27658 and 27659 describe flexor tendon repair, with the primary or secondary distinction determining the applicable code.

How many units should be reported?

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

Is the preoperative visit or routine postoperative care separately included?

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

Can modifier 50 be used when both legs are treated?

No. CMS indicates that bilateral adjustment does not apply and modifier 50 is inappropriate for this code.

Can an assistant or co-surgeon be reported?

Assistant-at-surgery payment may be available. Co-surgeon payment requires 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 27665PPRRVU2026_Oct_nonQPP.csv, line 3,000 (RVU26D)

Open CMS sourceHow we calculate rates

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