No office rate
27650 is for primary Achilles tendon repair. Choose 27654 when the operative circumstances call for secondary repair.
On this page
CMS RVU26D · Effective 2026-10-01
27654 Achilles repair Medicare reimbursement rates in Iowa
Reports operative reconstruction of an Achilles tendon when a secondary repair is needed, including procedures that use a graft to restore tendon continuity. Compare 27654 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 27654 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
$619.70
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.
Orthopedic surgery
About 27654: Secondary Achilles tendon repair
Reports operative reconstruction of an Achilles tendon when a secondary repair is needed, including procedures that use a graft to restore tendon continuity.
This code describes secondary surgery to restore continuity and function of the Achilles tendon, commonly after a rupture has not been repaired promptly or an earlier repair has failed. The surgeon exposes and prepares the tendon ends and may use a graft when needed to bridge or reinforce the defect. These procedures are typically performed by orthopedic or foot and ankle surgeons in an operating room.
Select this service when the operative report supports a secondary Achilles repair rather than primary repair of a rupture. Document the condition prompting secondary surgery, tendon findings, repair technique, and any graft use. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and others at 50%. For bilateral repair reported with modifier 50, payment is at 150%. Assistant-at-surgery services may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 27654
- 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 RVU10.27 · 51%
- Practice expense (office) RVU8.35 · 41%
- Malpractice RVU1.62 · 8%
5.4K
Medicare services in 2024 · #1817 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.
27654 compared with similar codes
Office rates for Iowa, from the same CMS release.
No office rate
27652 describes primary Achilles repair with graft. Graft use during a secondary Achilles repair is included in 27654.
No office rate
27658 applies to secondary repair of a lower-leg tendon other than the Achilles; 27654 is specific to the Achilles tendon.
No office rate
27659 is secondary repair with graft for a lower-leg tendon other than the Achilles. For secondary Achilles reconstruction, use 27654.
Compare 27654 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
Iowa →
Office / nonfacility
Unavailable
Facility
$619.70
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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 27654 in Iowa.
PPRRVU2026_Oct_nonQPP.csv
2,995
- Code
- 27654
- Physician work
- 10.27
- Practice expense
- 8.35
- Malpractice
- 1.62
GPCI2026.csv
53
- Locality
- Iowa
- Physician work
- 1.000
- Practice expense
- 0.915
- Malpractice
- 0.397
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 10.27 | × 1.000 | 10.2700 |
| Practice expense | 8.35 | × 0.915 | 7.6402 |
| Malpractice | 1.62 | × 0.397 | 0.6431 |
| Total RVUs | 18.5534 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Iowa$619.70
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 10.27 | 1 |
| Practice expense | 8.35 | 0.915 |
| Malpractice | 1.62 | 0.397 |
(10.27 × 1 + 8.35 × 0.915 + 1.62 × 0.397) × $33.4009 = $619.70
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.
27654 billing questions
How does this differ from 27650?
Use 27654 for a secondary Achilles repair. Code 27650 describes primary repair, generally when the rupture is addressed as a primary repair rather than a secondary reconstruction.
When is 27652 more appropriate?
27652 is a primary Achilles repair that uses a graft. A graft used during a secondary Achilles repair remains within the scope of 27654.
Can graft procurement be billed separately?
Graft use, including obtaining the graft, is part of the secondary Achilles repair represented by 27654.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How should bilateral repairs be reported?
For bilateral Achilles repairs, report modifier 50; CMS pays the bilateral procedure at 150%.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery services may be paid. Co-surgeons are paid only when supporting documentation is provided.
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.
2,99227648,,Injection for ankle x-ray,A,,0.94,5.11,,0.23,,0.14,6.19,1.31,0,000,0.00,0.00,0.00,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,99327650,,Repair achilles tendon,A,,8.98,8.26,NA,8.26,,1.45,18.69,18.69,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,99427652,,Repair/graft achilles tendon,A,,10.51,6.56,NA,6.56,,1.39,18.46,18.46,0,090,0.10,0.69,0.21,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,99527654,,Repair of achilles tendon,A,,10.27,8.35,NA,8.35,,1.62,20.24,20.24,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,99627656,,Repair leg fascia defect,A,,4.59,10.72,,4.41,,0.61,15.92,9.61,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,99727658,,Repair of leg tendon each,A,,4.99,4.94,NA,4.94,,0.76,10.69,10.69,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,99827659,,Repair of leg tendon each,A,,6.92,5.46,NA,5.46,,0.99,13.37,13.37,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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
5607202,LA,01,NEW ORLEANS,1.000,0.941,1.136