$526.15
Choose 27656 for primary repair of a leg flexor tendon without a graft; choose 27658 for secondary repair without a graft.
On this page
CMS RVU26D · Effective 2026-10-01
27658 in Delaware
Office / nonfacility
Not available in this setting
Base rate per service
Facility setting
$353.35
Base rate per service
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
Orthopedic surgery
About 27658: Secondary leg flexor tendon repair
Reports secondary repair without a graft of an injured flexor tendon in the leg, with one code unit for each tendon repaired.
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.
CMS billing rules for 27658
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU4.99 · 47%
- Practice expense (office) RVU4.94 · 46%
- Malpractice RVU0.76 · 7%
3K
Medicare services in 2024 · #2187 by national volume
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.
27658 compared with similar codes
Office rates for Delaware, from the same CMS release.
No office rate
Both describe secondary leg flexor tendon repair, but 27659 is used when a free graft is used.
No office rate
27665 is for secondary repair of a leg extensor tendon. Identify whether the repaired tendon is a flexor or extensor before selecting the code.
No office rate
27654 describes secondary repair of a ruptured Achilles tendon; 27658 is for a leg flexor tendon other than the Achilles.
The same code, a different location
How does Delaware compare?
27658 across payment areas
Same release and payment basis · bars start at $0
Delaware · This locality
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Other payment areas listed in Delaware appear first, followed by selected cross-country examples. The chart compares amounts, not distance.
The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.
Compare all 108 other payment areas
Alabama
Alabama · 27658
Office
Unavailable
Facility
$325.41
No comparable office rate is available.
Arkansas
Arkansas · 27658
Office
Unavailable
Facility
$321.48
No comparable office rate is available.
Arizona
Arizona · 27658
Office
Unavailable
Facility
$348.29
No comparable office rate is available.
Bakersfield
California · 27658
Office
Unavailable
Facility
$366.14
No comparable office rate is available.
Chico
California · 27658
Office
Unavailable
Facility
$363.95
No comparable office rate is available.
El Centro
California · 27658
Office
Unavailable
Facility
$364.08
No comparable office rate is available.
Fresno
California · 27658
Office
Unavailable
Facility
$363.95
No comparable office rate is available.
Hanford-Corcoran
California · 27658
Office
Unavailable
Facility
$363.95
No comparable office rate is available.
Madera
California · 27658
Office
Unavailable
Facility
$363.95
No comparable office rate is available.
Merced
California · 27658
Office
Unavailable
Facility
$363.95
No comparable office rate is available.
Modesto
California · 27658
Office
Unavailable
Facility
$363.95
No comparable office rate is available.
Napa
California · 27658
Office
Unavailable
Facility
$407.54
No comparable office rate is available.
Oxnard-Thousand Oaks-Ventura
California · 27658
Office
Unavailable
Facility
$382.18
No comparable office rate is available.
Redding
California · 27658
Office
Unavailable
Facility
$363.95
No comparable office rate is available.
Rest Of California
California · 27658
Office
Unavailable
Facility
$363.95
No comparable office rate is available.
Riverside-San Bernardino-Ontario
California · 27658
Office
Unavailable
Facility
$372.16
No comparable office rate is available.
Sacramento-Roseville-Folsom
California · 27658
Office
Unavailable
Facility
$378.17
No comparable office rate is available.
Salinas
California · 27658
Office
Unavailable
Facility
$376.68
No comparable office rate is available.
San Diego-Chula Vista-Carlsbad
California · 27658
Office
Unavailable
Facility
$382.77
No comparable office rate is available.
San Francisco-Oakland-Berkeley (Marin Cnty)
California · 27658
Office
Unavailable
Facility
$426.81
No comparable office rate is available.
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)
California · 27658
Office
Unavailable
Facility
$425.94
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
California · 27658
Office
Unavailable
Facility
$436.54
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
California · 27658
Office
Unavailable
Facility
$433.01
No comparable office rate is available.
San Luis Obispo-Paso Robles
California · 27658
Office
Unavailable
Facility
$371.05
No comparable office rate is available.
Santa Cruz-Watsonville
California · 27658
Office
Unavailable
Facility
$384.25
No comparable office rate is available.
Santa Maria-Santa Barbara
California · 27658
Office
Unavailable
Facility
$377.33
No comparable office rate is available.
Santa Rosa-Petaluma
California · 27658
Office
Unavailable
Facility
$387.90
No comparable office rate is available.
Stockton
California · 27658
Office
Unavailable
Facility
$363.95
No comparable office rate is available.
Vallejo
California · 27658
Office
Unavailable
Facility
$406.29
No comparable office rate is available.
Visalia
California · 27658
Office
Unavailable
Facility
$363.95
No comparable office rate is available.
Yuba City
California · 27658
Office
Unavailable
Facility
$363.95
No comparable office rate is available.
Colorado
Colorado · 27658
Office
Unavailable
Facility
$364.06
No comparable office rate is available.
Connecticut
Connecticut · 27658
Office
Unavailable
Facility
$378.42
No comparable office rate is available.
Fort Lauderdale
Florida · 27658
Office
Unavailable
Facility
$379.71
No comparable office rate is available.
Rest Of Florida
Florida · 27658
Office
Unavailable
Facility
$362.56
No comparable office rate is available.
Atlanta
Georgia · 27658
Office
Unavailable
Facility
$365.30
No comparable office rate is available.
Rest Of Georgia
Georgia · 27658
Office
Unavailable
Facility
$344.11
No comparable office rate is available.
Hawaii, Guam
Hawaii · 27658
Office
Unavailable
Facility
$368.97
No comparable office rate is available.
Iowa
Iowa · 27658
Office
Unavailable
Facility
$327.72
No comparable office rate is available.
Idaho
Idaho · 27658
Office
Unavailable
Facility
$330.48
No comparable office rate is available.
East St. Louis
Illinois · 27658
Office
Unavailable
Facility
$369.60
No comparable office rate is available.
Rest Of Illinois
Illinois · 27658
Office
Unavailable
Facility
$356.99
No comparable office rate is available.
Suburban Chicago
Illinois · 27658
Office
Unavailable
Facility
$382.27
No comparable office rate is available.
Indiana
Indiana · 27658
Office
Unavailable
Facility
$331.96
No comparable office rate is available.
Kansas
Kansas · 27658
Office
Unavailable
Facility
$328.62
No comparable office rate is available.
Kentucky
Kentucky · 27658
Office
Unavailable
Facility
$336.58
No comparable office rate is available.
New Orleans
Louisiana · 27658
Office
Unavailable
Facility
$350.77
No comparable office rate is available.
Rest Of Louisiana
Louisiana · 27658
Office
Unavailable
Facility
$337.01
No comparable office rate is available.
Metropolitan Boston
Massachusetts · 27658
Office
Unavailable
Facility
$393.11
No comparable office rate is available.
Rest Of Massachusetts
Massachusetts · 27658
Office
Unavailable
Facility
$363.31
No comparable office rate is available.
Baltimore/Surr. Cntys
Maryland · 27658
Office
Unavailable
Facility
$377.78
No comparable office rate is available.
Rest Of Maryland
Maryland · 27658
Office
Unavailable
Facility
$358.62
No comparable office rate is available.
Rest Of Maine
Maine · 27658
Office
Unavailable
Facility
$334.26
No comparable office rate is available.
Southern Maine
Maine · 27658
Office
Unavailable
Facility
$346.20
No comparable office rate is available.
Detroit
Michigan · 27658
Office
Unavailable
Facility
$368.69
No comparable office rate is available.
Rest Of Michigan
Michigan · 27658
Office
Unavailable
Facility
$345.98
No comparable office rate is available.
Minnesota
Minnesota · 27658
Office
Unavailable
Facility
$343.97
No comparable office rate is available.
Metropolitan Kansas City
Missouri · 27658
Office
Unavailable
Facility
$346.41
No comparable office rate is available.
Metropolitan St. Louis
Missouri · 27658
Office
Unavailable
Facility
$349.19
No comparable office rate is available.
Rest Of Missouri
Missouri · 27658
Office
Unavailable
Facility
$333.63
No comparable office rate is available.
Mississippi
Mississippi · 27658
Office
Unavailable
Facility
$327.50
No comparable office rate is available.
Montana**
Montana · 27658
Office
Unavailable
Facility
$357.00
No comparable office rate is available.
North Carolina
North Carolina · 27658
Office
Unavailable
Facility
$336.84
No comparable office rate is available.
North Dakota**
North Dakota · 27658
Office
Unavailable
Facility
$341.98
No comparable office rate is available.
Nebraska
Nebraska · 27658
Office
Unavailable
Facility
$328.56
No comparable office rate is available.
New Hampshire
New Hampshire · 27658
Office
Unavailable
Facility
$360.65
No comparable office rate is available.
Northern Nj
New Jersey · 27658
Office
Unavailable
Facility
$395.68
No comparable office rate is available.
Rest Of New Jersey
New Jersey · 27658
Office
Unavailable
Facility
$381.36
No comparable office rate is available.
New Mexico
New Mexico · 27658
Office
Unavailable
Facility
$348.46
No comparable office rate is available.
Nevada**
Nevada · 27658
Office
Unavailable
Facility
$352.98
No comparable office rate is available.
Nyc Suburbs/Long Island
New York · 27658
Office
Unavailable
Facility
$420.66
No comparable office rate is available.
Poughkpsie/N Nyc Suburbs
New York · 27658
Office
Unavailable
Facility
$385.56
No comparable office rate is available.
Queens
New York · 27658
Office
Unavailable
Facility
$408.97
No comparable office rate is available.
Rest Of New York
New York · 27658
Office
Unavailable
Facility
$341.27
No comparable office rate is available.
Ohio
Ohio · 27658
Office
Unavailable
Facility
$342.90
No comparable office rate is available.
Oklahoma
Oklahoma · 27658
Office
Unavailable
Facility
$333.74
No comparable office rate is available.
Portland
Oregon · 27658
Office
Unavailable
Facility
$371.54
No comparable office rate is available.
Rest Of Oregon
Oregon · 27658
Office
Unavailable
Facility
$348.86
No comparable office rate is available.
Metropolitan Philadelphia
Pennsylvania · 27658
Office
Unavailable
Facility
$371.72
No comparable office rate is available.
Rest Of Pennsylvania
Pennsylvania · 27658
Office
Unavailable
Facility
$342.13
No comparable office rate is available.
Puerto Rico
Puerto Rico · 27658
Office
Unavailable
Facility
$358.49
No comparable office rate is available.
Rhode Island
Rhode Island · 27658
Office
Unavailable
Facility
$362.93
No comparable office rate is available.
South Carolina
South Carolina · 27658
Office
Unavailable
Facility
$340.71
No comparable office rate is available.
South Dakota**
South Dakota · 27658
Office
Unavailable
Facility
$340.20
No comparable office rate is available.
Tennessee
Tennessee · 27658
Office
Unavailable
Facility
$330.29
No comparable office rate is available.
Austin
Texas · 27658
Office
Unavailable
Facility
$364.07
No comparable office rate is available.
Beaumont
Texas · 27658
Office
Unavailable
Facility
$340.40
No comparable office rate is available.
Brazoria
Texas · 27658
Office
Unavailable
Facility
$351.32
No comparable office rate is available.
Dallas
Texas · 27658
Office
Unavailable
Facility
$354.29
No comparable office rate is available.
Fort Worth
Texas · 27658
Office
Unavailable
Facility
$352.97
No comparable office rate is available.
Galveston
Texas · 27658
Office
Unavailable
Facility
$352.87
No comparable office rate is available.
Houston
Texas · 27658
Office
Unavailable
Facility
$366.78
No comparable office rate is available.
Rest Of Texas
Texas · 27658
Office
Unavailable
Facility
$346.18
No comparable office rate is available.
Utah
Utah · 27658
Office
Unavailable
Facility
$344.57
No comparable office rate is available.
Virginia
Virginia · 27658
Office
Unavailable
Facility
$346.79
No comparable office rate is available.
Virgin Islands
United States Virgin Islands · 27658
Office
Unavailable
Facility
$358.49
No comparable office rate is available.
Vermont
Vermont · 27658
Office
Unavailable
Facility
$342.87
No comparable office rate is available.
Rest Of Washington
Washington · 27658
Office
Unavailable
Facility
$361.90
No comparable office rate is available.
Seattle (King Cnty)
Washington · 27658
Office
Unavailable
Facility
$398.20
No comparable office rate is available.
Wisconsin
Wisconsin · 27658
Office
Unavailable
Facility
$332.56
No comparable office rate is available.
West Virginia
West Virginia · 27658
Office
Unavailable
Facility
$346.38
No comparable office rate is available.
Wyoming**
Wyoming · 27658
Office
Unavailable
Facility
$350.46
No comparable office rate is available.
See how rates vary across the country
27658 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.
Explore a state
Local rates. Clear comparisons.
Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.
View all state and territory rates as a table
| State / territory | Rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
Where does this rate apply?
Delaware is a Medicare payment area. Our Census mapping connects it to 79 cities and communities in Delaware, including the examples shown here.
Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.
Use this rate
What is a percentage of Medicare worth?
Turn a percentage into dollars for 27658 in Delaware. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$388.69
$353.35 × 110% = $388.69
A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.
Working with a whole code list?
Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.
How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 27658 in Delaware.
PPRRVU2026_Oct_nonQPP.csv
2,997
- Code
- 27658
- Physician work
- 4.99
- Practice expense
- 4.94
- Malpractice
- 0.76
GPCI2026.csv
40
- Locality
- Delaware
- Physician work
- 1.005
- Practice expense
- 0.988
- Malpractice
- 0.899
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 4.99 | × 1.005 | 5.0149 |
| Practice expense | 4.94 | × 0.988 | 4.8807 |
| Malpractice | 0.76 | × 0.899 | 0.6832 |
| Total RVUs | 10.5789 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Delaware$353.35
Open 27658 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 4.99 | 1.005 |
| Practice expense | 4.94 | 0.988 |
| Malpractice | 0.76 | 0.899 |
(4.99 × 1.005 + 4.94 × 0.988 + 0.76 × 0.899) × $33.4009 = $353.35
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
How this rate has changed
27658 · Office / nonfacility
Rate unavailable
Effective 2026-10-01
A rate is unavailable in one of these releases, so a change cannot be calculated.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
What changed, release by release
Explore release dates and calculate this code in an earlier period →
Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.
Inspect every release and its CMS source
| Effective from | Office / nonfacility | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $353.35 | RVU26D |
| 2026-07-01 | Not available in this setting | $353.35 | RVU26C |
| 2026-04-01 | Not available in this setting | $353.35 | RVU26B |
| 2026-01-01 | Not available in this setting | $353.35 | RVU26A |
| 2025-10-01 | Not available in this setting | $366.96 | RVU25D |
| 2025-07-01 | Not available in this setting | $366.96 | RVU25C |
| 2025-04-01 | Not available in this setting | $366.96 | RVU25B |
| 2025-01-01 | Not available in this setting | $366.96 | RVU25A |
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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
2,99427652,,Repair/graft achilles tendon,A,,10.51,6.56,NA,6.56,,1.39,18.46,18.46,0,090,0.10,0.69,0.21,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,99527654,,Repair of achilles tendon,A,,10.27,8.35,NA,8.35,,1.62,20.24,20.24,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,99627656,,Repair leg fascia defect,A,,4.59,10.72,,4.41,,0.61,15.92,9.61,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,99727658,,Repair of leg tendon each,A,,4.99,4.94,NA,4.94,,0.76,10.69,10.69,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,99827659,,Repair of leg tendon each,A,,6.92,5.46,NA,5.46,,0.99,13.37,13.37,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,99927664,,Repair of leg tendon each,A,,4.61,4.98,NA,4.98,,0.71,10.30,10.30,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,00027665,,Repair of leg tendon each,A,,5.43,5.66,NA,5.66,,0.87,11.96,11.96,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3704112,CO,01,COLORADO,1.012,1.064,0.781
3813102,CT,00,CONNECTICUT,1.020,1.077,1.210
3912202,DC,01,DC + MD/VA SUBURBS,1.054,1.178,1.113
4012102,DE,01,DELAWARE,1.005,0.988,0.899
4109102,FL,03,FORT LAUDERDALE,1.000,1.013,1.808
4209102,FL,04,MIAMI,1.000,1.041,2.529
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503