Billing code 27654: Achilles repairMedicare rate & RVUs in Oregon
Reports operative reconstruction of an Achilles tendon when a secondary repair is needed, including procedures that use a graft to restore tendon continuity.
CMS doesn’t publish an office rate for 27654 in Oregon.
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 27654 covers
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.
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.
Where 27654 pays more and less in Oregon
| Payment locality | Office | Facility |
|---|---|---|
| Portland | Unavailable | $698.63 |
| Rest Of Oregon | Unavailable | $658.85 |
How the 27654 rate is calculated
Each of 27654’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 · 27654
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 10.27Practice expense 8.35Malpractice 1.62
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 27654
27654 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 27654
Achilles 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 · 27654
Achilles 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
27654 without 50 · national facility
$676.03
Achilles repair
27654-50 · Bilateral: 150%
$1,014.05
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).
27654 compared with similar codes
Compare codes
27654 vs 27650 vs 27652 vs 27658 vs 27659: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 27650Achilles repair
- 27650 is for primary Achilles tendon repair. Choose 27654 when the operative circumstances call for secondary repair.
- 27652Achilles repair
- 27652 describes primary Achilles repair with graft. Graft use during a secondary Achilles repair is included in 27654.
- 27658Tendon repair
- 27658 applies to secondary repair of a lower-leg tendon other than the Achilles; 27654 is specific to the Achilles tendon.
- 27659Leg tendon repair
- 27659 is secondary repair with graft for a lower-leg tendon other than the Achilles. For secondary Achilles reconstruction, use 27654.
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 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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