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CMS RVU26D · Effective 2026-10-01

27396 Tendon transfer Medicare reimbursement rates in Iowa

Reports surgical redirection of one thigh tendon to change its pull and improve movement or stability when the operative plan transfers a single tendon. Compare 27396 office and facility rates across CMS payment localities in Iowa.

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 27396 in Iowa?

Iowa 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

$531.83

1 of 1 localities have a supported rate.

Payment area: Iowa

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.

Find 27396 in your payment locality →

Orthopedic surgery

About 27396: Single thigh tendon transfer

Reports surgical redirection of one thigh tendon to change its pull and improve movement or stability when the operative plan transfers a single tendon.

An orthopedic surgeon redirects one tendon in the thigh by moving its attachment to a different site, changing the direction of its pull to improve movement or stability. This may be part of reconstructive surgery for a functional imbalance or loss of muscle action. The procedure is generally performed in a hospital or ambulatory surgery center; Medicare recorded facility services for this code in 2024 and no office services.

Select this code when the operative report supports transfer or transplantation of one thigh tendon; a transfer involving multiple tendons is distinguished by the multiple-tendon code. Documentation should identify the tendon, the original and new attachment sites, the reason for redirecting its action, and the work performed. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in the same session, the highest-valued procedure is paid in full and others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is not permitted.

CMS billing rules for 27396

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 RVU7.95 · 45%
  • Practice expense (office) RVU7.98 · 45%
  • Malpractice RVU1.69 · 10%

59

Medicare services in 2024 · #5252 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.

27396 compared with similar codes

Office rates for Iowa, from the same CMS release.

27397

Tendon transfer

Multiple thigh tendons

No office rate

Choose 27396 for a single transferred thigh tendon and 27397 when multiple thigh tendons are transferred.

27393

Tendon lengthening

Single hamstring tendon

No office rate

Code 27393 describes lengthening a thigh tendon, not redirecting its attachment as in a tendon transfer.

27386

Thigh muscle repair

With graft

No office rate

Code 27386 concerns repair or grafting of a thigh tendon; use 27396 when the documented procedure transfers one tendon to a new attachment.

Compare 27396 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

Office and facility base rates · shared scale starting at $0
  • Iowa →

    Office / nonfacility

    Unavailable

    Facility

    $531.83

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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 27396 in Iowa.

PPRRVU2026_Oct_nonQPP.csv

2,872

Code
27396
Physician work
7.95
Practice expense
7.98
Malpractice
1.69

GPCI2026.csv

53

Locality
Iowa
Physician work
1.000
Practice expense
0.915
Malpractice
0.397
Facility calculation for 27396 in Iowa
ComponentRVULocality factorAdjusted
Physician work7.95× 1.0007.9500
Practice expense7.98× 0.9157.3017
Malpractice1.69× 0.3970.6709
Total RVUs15.9226
Conversion factor× 33.4009

Facility rate, Iowa$531.83

Explore RVUs, geographic factors and the full formula

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work7.951
Practice expense7.980.915
Malpractice1.690.397

(7.95 × 1 + 7.98 × 0.915 + 1.69 × 0.397) × $33.4009 = $531.83

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.

27396 billing questions

How does this differ from 27397?

This code is for transfer of one thigh tendon. Code 27397 is for transfer of multiple thigh tendons.

How does a tendon transfer differ from tendon lengthening?

A transfer changes where a tendon acts by redirecting its attachment. Lengthening changes tendon length rather than transferring its attachment.

What should the operative report document?

Document the tendon transferred, its original and new attachment sites, the clinical reason for redirection, and the procedure performed.

How is bilateral surgery reported?

For bilateral procedures, report modifier 50; CMS pays the bilateral procedure at 150%.

What postoperative care is included?

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 paid?

Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation.

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.

RVUs for 27396PPRRVU2026_Oct_nonQPP.csv, line 2,872 (RVU26D)
Geographic factors for IowaGPCI2026.csv, line 53 (RVU26D)