Billing code 27386: Thigh muscle repairMedicare rate & RVUs in Ohio
Reports operative reconstruction or augmentation of a thigh muscle when a graft is used to repair a substantial muscle injury or defect.
CMS doesn’t publish an office rate for 27386 in Ohio.
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 27386 covers
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.
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 in Ohio
| Payment locality | Office | Facility |
|---|---|---|
| Ohio | Unavailable | $775.64 |
How the 27386 rate is calculated
Each of 27386’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 · 27386
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 10.85Practice expense 11.10Malpractice 2.22
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 27386
27386 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 27386
Thigh muscle repair
| 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 · 27386
Thigh muscle repair
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
27386 without 50 · national facility
$807.30
Thigh muscle repair
27386-50 · Bilateral: 150%
$1,210.95
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).
27386 compared with similar codes
Compare codes
27386 vs 27385 vs 27380 vs 27381: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 27385Thigh muscle repair
- Use 27386 for graft-based thigh-muscle reconstruction or augmentation. Use 27385 for the related thigh-muscle repair without that graft-based service.
- 27380Patellar tendon repair
- This code concerns repair of the kneecap tendon. Choose 27386 only when the repaired structure is a thigh muscle.
- 27381Patellar tendon repair
- This code concerns graft repair of the kneecap tendon; 27386 concerns graft reconstruction or augmentation of a thigh muscle.
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 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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