No office rate
Use 27386 for graft-based thigh-muscle reconstruction or augmentation. Use 27385 for the related thigh-muscle repair without that graft-based service.
On this page
CMS RVU26D · Effective 2026-10-01
27386 Thigh muscle repair Medicare reimbursement rates in Indiana
Reports operative reconstruction or augmentation of a thigh muscle when a graft is used to repair a substantial muscle injury or defect. Compare 27386 office and facility rates across CMS payment localities in Indiana.
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 27386 in Indiana?
Indiana 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
$742.12
1 of 1 localities have a supported rate.
Payment area: Indiana
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 27386: Thigh muscle reconstruction with graft
Reports operative reconstruction or augmentation of a thigh muscle when a graft is used to repair a substantial muscle injury or defect.
An orthopedic surgeon uses this service to reconstruct or augment a thigh muscle when the damaged tissue cannot be adequately repaired without graft material. It may be performed in an operating room for a significant tear or defect involving a thigh muscle. The operative report should identify the muscle treated, the injury or defect, and the graft-based reconstruction performed; the code is reported for each muscle treated.
This is a major procedure with 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, Medicare pays the highest-valued procedure in full and other procedures at 50%. For bilateral reporting with modifier 50, payment is at 150%. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 27386
- 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 RVU10.85 · 45%
- Practice expense (office) RVU11.10 · 46%
- Malpractice RVU2.22 · 9%
1.3K
Medicare services in 2024 · #2749 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.
27386 compared with similar codes
Office rates for Indiana, from the same CMS release.
No office rate
This code concerns repair of the kneecap tendon. Choose 27386 only when the repaired structure is a thigh muscle.
No office rate
This code concerns graft repair of the kneecap tendon; 27386 concerns graft reconstruction or augmentation of a thigh muscle.
Compare 27386 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
Indiana →
Office / nonfacility
Unavailable
Facility
$742.12
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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 27386 in Indiana.
PPRRVU2026_Oct_nonQPP.csv
2,865
- Code
- 27386
- Physician work
- 10.85
- Practice expense
- 11.10
- Malpractice
- 2.22
GPCI2026.csv
52
- Locality
- Indiana
- Physician work
- 1.000
- Practice expense
- 0.927
- Malpractice
- 0.486
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 10.85 | × 1.000 | 10.8500 |
| Practice expense | 11.10 | × 0.927 | 10.2897 |
| Malpractice | 2.22 | × 0.486 | 1.0789 |
| Total RVUs | 22.2186 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Indiana$742.12
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 10.85 | 1 |
| Practice expense | 11.1 | 0.927 |
| Malpractice | 2.22 | 0.486 |
(10.85 × 1 + 11.1 × 0.927 + 2.22 × 0.486) × $33.4009 = $742.12
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.
27386 billing questions
How does this differ from 27385?
Report 27386 when the thigh muscle reconstruction or augmentation uses a graft. Code 27385 is the related thigh-muscle repair code without the graft-based distinction.
What documentation supports reporting this code?
Document the specific thigh muscle, the injury or defect, and the graft used in the operative reconstruction or augmentation. The record should support the number of muscles treated.
Can modifier 50 be used for bilateral treatment?
Yes. CMS treats this as a bilateral procedure when reported with modifier 50 and pays it at 150%.
How does Medicare handle other procedures performed in the same session?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and the others at 50%.
Is postoperative care included in this service?
Yes. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. 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 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.
2,86227380,,Repair of kneecap tendon,A,,7.26,9.14,NA,9.14,,1.50,17.90,17.90,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,86327381,,Repair/graft kneecap tendon,A,,10.49,10.53,NA,10.53,,2.19,23.21,23.21,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,86427385,,Repair of thigh muscle,A,,6.76,9.49,NA,9.49,,1.37,17.62,17.62,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,86527386,,Repair/graft of thigh muscle,A,,10.85,11.10,NA,11.10,,2.22,24.17,24.17,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,86627390,,Incision of thigh tendon,A,,5.39,6.16,NA,6.16,,1.05,12.60,12.60,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,86727391,,Incision of thigh tendons,A,,7.30,7.70,NA,7.70,,1.52,16.52,16.52,0,090,0.10,0.69,0.21,2,0,0,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,86827392,,Incision of thigh tendons,A,,9.39,8.78,NA,8.78,,2.00,20.17,20.17,0,090,0.10,0.69,0.21,2,2,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4906102,IL,12,EAST ST. LOUIS,1.000,0.920,2.014
5006102,IL,15,SUBURBAN CHICAGO,1.007,1.027,1.772
5106102,IL,99,REST OF ILLINOIS,1.000,0.913,1.563
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915