Billing code 27659: Leg tendon repairMedicare rate & RVUs in Florida
Report this service for secondary reconstruction of a disrupted lower-leg tendon when a free tendon graft is used to restore continuity.
CMS doesn’t publish an office rate for 27659 in Florida.
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 9 sections
What 27659 covers
An orthopedic or foot-and-ankle surgeon uses this service to reconstruct a disrupted tendon in the leg when a secondary repair requires a free graft. It applies to repair of a lower-leg tendon other than the Achilles tendon, which has its own code family. The graft bridges or reinforces the tendon defect as part of restoring tendon continuity, typically during an operative repair in a hospital or ambulatory surgery center.
Report one unit for each tendon repaired, and document the tendon, the disruption, the secondary nature of the repair, and use of a free graft. This major surgery has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate for this code. Assistant-at-surgery services may be paid; co-surgeons require 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 27659 pays more and less in Florida
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Fort Lauderdale | Unavailable | $475.66 |
| Miami | Unavailable | $504.61 |
| Rest Of Florida | Unavailable | $455.18 |
How the 27659 rate is calculated
Each of 27659’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 · 27659
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 6.92Practice expense 5.46Malpractice 0.99
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 27659
27659 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 27659
Leg tendon repair
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.69/0.21 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 27659
Leg 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.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
27659 without 51 · national facility
$446.57
Leg tendon repair
27659-51 · Second procedure: 50%
$223.29
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%).
27659 compared with similar codes
Compare codes
27659 vs 27658 vs 27654 vs 27665: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 27658Tendon repair
- Both represent secondary repair of a disrupted leg tendon. Choose 27659 when a free graft is used; 27658 is the counterpart without a free graft.
- 27654Achilles repair
- 27654 is specific to secondary repair of the Achilles tendon. Use 27659 for a qualifying disrupted leg tendon other than the Achilles.
- 27665Tendon repair
- 27665 describes primary repair of a leg extensor tendon with a free graft. 27659 is for secondary repair of a disrupted leg tendon.
27659 billing questions
How does this differ from 27658?
27659 is for secondary repair of a disrupted leg tendon using a free graft. 27658 describes the corresponding secondary repair without a free graft.
Can this code be used for a secondary Achilles repair?
No. Achilles tendon repairs are represented by the Achilles-specific codes, including 27654 for secondary repair. Use 27659 for a qualifying non-Achilles leg tendon.
How many units should be reported?
The code is reported for each tendon repaired. Document the specific tendon treated and the graft used for each repair.
Should modifier 50 be appended for repairs on both sides?
No. The CMS bilateral adjustment does not apply, and modifier 50 is inappropriate for this code.
What assistant or co-surgeon billing rules apply?
Assistant-at-surgery services may be paid. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
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
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