Billing code 27690: Tendon transferMedicare rate & RVUs in Illinois
Reports transfer or transplantation of one tendon in the lower leg or ankle to redirect its pull and improve movement or support.
CMS doesn’t publish an office rate for 27690 in Illinois.
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 27690 covers
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.
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 27690 pays more and less in Illinois
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Chicago | Unavailable | $670.47 |
| East St. Louis | Unavailable | $633.16 |
| Rest Of Illinois | Unavailable | $610.82 |
| Suburban Chicago | Unavailable | $652.52 |
How the 27690 rate is calculated
Each of 27690’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 · 27690
RVUs × geographic indexes × conversion factor
Work8.94
8.94 RVUs× 1.000 GPCI
Practice expense7.91
7.91 RVUs× 1.000 GPCI
Malpractice1.36
1.36 RVUs× 1.000 GPCI
Adjusted RVUs
18.2100
Conversion factor
$33.4009
Medicare rate
$608.23
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 27690
27690 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 27690
Tendon transfer
| 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) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| 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 · 27690
Tendon transfer
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 50 · payment effect
With and without the modifier
27690 without 50 · national facility
$608.23
Tendon transfer
27690-50 · Bilateral: 150%
$912.35
Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).
27690 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 27691Tendon transfer
- 27690 covers the first transferred tendon; 27691 is for each additional tendon transferred in the same operative service.
- 27685Tendon lengthening
- Choose 27685 when the surgeon lengthens or shortens a tendon. Choose 27690 when one tendon is rerouted to assume a different function.
- 27680Tendon release
- 27680 addresses release of tendon adhesions. It does not describe transferring a tendon to a new attachment.
- 27658Tendon repair
- 27658 describes repair of a leg tendon, whereas 27690 describes transferring one tendon to redirect its function.
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 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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