No office rate
Choose 27691 for a deep tendon transfer and 27690 for a superficial tendon transfer. The operative report should establish which tendon was rerouted.
On this page
CMS RVU26D · Effective 2026-10-01
27691 Tendon transfer Medicare reimbursement rates in Nebraska
Reports operative rerouting of one deep lower-leg tendon to a new attachment, such as a posterior tibial transfer to address foot drop. Compare 27691 office and facility rates across CMS payment localities in Nebraska.
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 27691 in Nebraska?
Nebraska 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
$642.61
1 of 1 localities have a supported rate.
Payment area: Nebraska
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 27691: Deep lower-leg tendon transfer
Reports operative rerouting of one deep lower-leg tendon to a new attachment, such as a posterior tibial transfer to address foot drop.
An orthopedic surgeon mobilizes a deep tendon and redirects it to a different attachment to change the pull on the foot or ankle. A posterior tibial tendon transfer to help address foot drop is a typical example; deep tendon transfer may also be part of reconstructive surgery for tendon imbalance. These procedures are generally performed in an operating room, commonly in a hospital or ambulatory surgery setting.
Report this code for one deep lower-leg tendon transferred or rerouted, rather than a tendon that is simply repaired or lengthened. The operative report should identify the tendon, its original and new attachment, and the reason for the transfer. An additional tendon may be reported with the applicable add-on code. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care. When multiple procedures occur in one session, the highest-valued 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 27691
- 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 RVU10.23 · 49%
- Practice expense (office) RVU9.04 · 43%
- Malpractice RVU1.76 · 8%
6.6K
Medicare services in 2024 · #1694 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.
27691 compared with similar codes
Office rates for Nebraska, from the same CMS release.
No office rate
27692 represents an additional tendon in a transfer procedure; it is not the primary code for the first tendon.
$629.24
27685 is used for tendon lengthening. Use 27691 when the tendon is redirected to a different attachment rather than lengthened.
No office rate
27658 addresses tendon repair. A transfer to a new attachment is the distinguishing service for 27691.
Compare 27691 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
Nebraska →
Office / nonfacility
Unavailable
Facility
$642.61
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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 27691 in Nebraska.
PPRRVU2026_Oct_nonQPP.csv
3,009
- Code
- 27691
- Physician work
- 10.23
- Practice expense
- 9.04
- Malpractice
- 1.76
GPCI2026.csv
72
- Locality
- Nebraska
- Physician work
- 1.000
- Practice expense
- 0.923
- Malpractice
- 0.378
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 10.23 | × 1.000 | 10.2300 |
| Practice expense | 9.04 | × 0.923 | 8.3439 |
| Malpractice | 1.76 | × 0.378 | 0.6653 |
| Total RVUs | 19.2392 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Nebraska$642.61
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 10.23 | 1 |
| Practice expense | 9.04 | 0.923 |
| Malpractice | 1.76 | 0.378 |
(10.23 × 1 + 9.04 × 0.923 + 1.76 × 0.378) × $33.4009 = $642.61
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.
27691 billing questions
How is this code distinguished from 27690?
This code is for transfer of a deep lower-leg tendon. Code 27690 describes transfer of a superficial tendon.
Can an additional tendon be reported?
Yes. Report 27692 for an additional tendon when the documentation supports the additional transfer and the code's add-on requirements are met.
Does a tendon repair qualify as a transfer?
No. This code describes rerouting a tendon to a new attachment; repair codes describe treatment of a tendon injury without that transfer.
How does the 90-day global period affect postoperative billing?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
How is bilateral surgery reported under the CMS facts?
For a bilateral procedure reported with modifier 50, CMS pays at 150%. Multiple procedures in the same session are subject to the standard multiple procedure reduction.
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.
3,00627686,,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
3,01227696,,Repair of ankle ligaments,A,,8.37,5.79,NA,5.79,,1.12,15.28,15.28,0,090,0.10,0.69,0.21,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6905302,MO,01,METROPOLITAN ST. LOUIS,1.000,0.952,1.002
7005302,MO,99,REST OF MISSOURI,1.000,0.862,0.974
7103202,MT,01,MONTANA**,1.000,1.000,0.998
7205402,NE,00,NEBRASKA,1.000,0.923,0.378
7301312,NV,00,NEVADA**,1.000,1.001,0.833
7414312,NH,40,NEW HAMPSHIRE,1.000,1.041,0.875
7512402,NJ,01,NORTHERN NJ,1.063,1.160,1.068