No office rate
27690 covers the first transferred tendon; 27691 is for each additional tendon transferred in the same operative service.
On this page
CMS RVU26D · Effective 2026-10-01
27690 Tendon transfer Medicare reimbursement rates in Hawaii
Reports transfer or transplantation of one tendon in the lower leg or ankle to redirect its pull and improve movement or support. Compare 27690 office and facility rates across CMS payment localities in Hawaii.
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.
What does Medicare pay for 27690 in Hawaii?
Hawaii has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$625.30
1 of 1 localities have a supported rate.
Payment area: Hawaii, Guam
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Orthopedic surgery
About 27690: Single lower-leg tendon transfer
Reports transfer or transplantation of one tendon in the lower leg or ankle to redirect its pull and improve movement or support.
An orthopedic surgeon transfers or transplants one tendon in the lower-leg or ankle region, rerouting its attachment so it can perform a different function. A familiar example is transferring the posterior tibial tendon to help restore active foot lifting in a patient with foot drop. The service is generally performed in an operating room; the operative report should identify the donor tendon, its new attachment, and the functional problem being addressed.
Report this code for the transfer of one tendon, not for simply repairing a torn tendon, releasing adhesions, or lengthening a tendon. Document the tendon’s original and new course or attachment and the work performed. CMS assigns a 90-day global period, which includes 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. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 27690
- 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 procedure with modifier 50 is paid at 150%.
- 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 RVU8.94 · 49%
- Practice expense (office) RVU7.91 · 43%
- Malpractice RVU1.36 · 7%
1.6K
Medicare services in 2024 · #2604 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.
27690 compared with similar codes
Office rates for Hawaii, from the same CMS release.
$728.13
Choose 27685 when the surgeon lengthens or shortens a tendon. Choose 27690 when one tendon is rerouted to assume a different function.
No office rate
27680 addresses release of tendon adhesions. It does not describe transferring a tendon to a new attachment.
No office rate
27658 describes repair of a leg tendon, whereas 27690 describes transferring one tendon to redirect its function.
Compare 27690 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Hawaii, Guam →
Office / nonfacility
Unavailable
Facility
$625.30
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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 27690 in Hawaii, Guam.
PPRRVU2026_Oct_nonQPP.csv
3,008
- Code
- 27690
- Physician work
- 8.94
- Practice expense
- 7.91
- Malpractice
- 1.36
GPCI2026.csv
46
- Locality
- Hawaii, Guam
- Physician work
- 1.000
- Practice expense
- 1.137
- Malpractice
- 0.579
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 8.94 | × 1.000 | 8.9400 |
| Practice expense | 7.91 | × 1.137 | 8.9937 |
| Malpractice | 1.36 | × 0.579 | 0.7874 |
| Total RVUs | 18.7211 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Hawaii, Guam$625.30
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 8.94 | 1 |
| Practice expense | 7.91 | 1.137 |
| Malpractice | 1.36 | 0.579 |
(8.94 × 1 + 7.91 × 1.137 + 1.36 × 0.579) × $33.4009 = $625.30
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.
27690 billing questions
When should I report 27690 rather than a tendon repair code?
Use 27690 when the surgeon reroutes one tendon to provide a different function. A repair restores continuity of an injured tendon rather than changing its course or functional attachment.
How is an additional transferred tendon reported?
Code 27691 describes each additional tendon transferred with the primary single-tendon service. The operative report should establish the number of tendons transferred.
Is routine postoperative care separately billable?
Related postoperative care during the 90-day global period is included, as is the day-before preoperative visit. Separate reporting requires a service outside the care included in that global period.
How does CMS handle bilateral reporting?
When the procedure is performed bilaterally and reported with modifier 50, CMS pays at 150%. The documentation should support the service on both sides.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be available. Co-surgeon payment requires supporting documentation; CMS does not permit team surgery payment.
What documentation supports 27690?
Document the tendon transferred, its original and new attachment or route, and the functional reason for redirecting it. The record should make clear that one tendon was transferred rather than repaired, released, or lengthened.
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.
3,00527685,,Revision of lower leg tendon,A,,6.52,12.97,,5.84,,0.92,20.41,13.28,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,00627686,,Revise lower leg tendons,A,,7.56,6.28,NA,6.28,,1.22,15.06,15.06,0,090,0.10,0.69,0.21,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,00727687,,Revision of calf tendon,A,,6.25,5.77,NA,5.77,,0.98,13.00,13.00,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,00827690,,Revise lower leg tendon,A,,8.94,7.91,NA,7.91,,1.36,18.21,18.21,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,00927691,,Revise lower leg tendon,A,,10.23,9.04,NA,9.04,,1.76,21.03,21.03,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,01027692,,Revise additional leg tendon,A,,1.82,0.51,NA,0.51,,0.35,2.68,2.68,0,ZZZ,0.00,0.00,0.00,0,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,01127695,,Repair of ankle ligament,A,,6.53,6.34,NA,6.34,,1.07,13.94,13.94,0,090,0.10,0.69,0.21,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503
4410212,GA,01,ATLANTA,1.003,1.016,1.201
4510212,GA,99,REST OF GEORGIA,1.000,0.892,1.192
4601212,HI,01,"HAWAII, GUAM",1.000,1.137,0.579
4702202,ID,00,IDAHO,1.000,0.920,0.473
4806102,IL,16,CHICAGO,1.007,1.005,2.295
4906102,IL,12,EAST ST. LOUIS,1.000,0.920,2.014