No office rate
This code describes direct thigh muscle repair without a graft. Choose 27386 when graft material is used in the repair.
On this page
CMS RVU26D · Effective 2026-10-01
27385 Thigh muscle repair Medicare reimbursement rates in Rhode Island
Reports operative direct repair of a torn or ruptured thigh muscle when the surgeon repairs the muscle without using a graft. Compare 27385 office and facility rates across CMS payment localities in Rhode Island.
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 27385 in Rhode Island?
Rhode Island 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
$598.33
1 of 1 localities have a supported rate.
Payment area: Rhode Island
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 27385: Primary thigh muscle tear repair
Reports operative direct repair of a torn or ruptured thigh muscle when the surgeon repairs the muscle without using a graft.
This service involves surgically bringing together and repairing a torn or ruptured muscle in the thigh without graft material. An orthopedic surgeon commonly performs the repair in an operating room for an injury that requires operative treatment; the code describes muscle repair, rather than repair of the kneecap tendon or a thigh tendon. The operative report should identify the injured muscle and the repair performed.
Report the code when documentation supports direct repair without a graft; use the graft-repair sibling when graft material is used. The service has a 90-day global period, including 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 other procedures are paid at 50%. Bilateral reporting with modifier 50 is paid at 150%. An assistant at surgery may be paid; co-surgeons require supporting documentation, and team surgery is not permitted.
CMS billing rules for 27385
- 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 RVU6.76 · 38%
- Practice expense (office) RVU9.49 · 54%
- Malpractice RVU1.37 · 8%
7.7K
Medicare services in 2024 · #1608 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.
27385 compared with similar codes
Office rates for Rhode Island, from the same CMS release.
Compare 27385 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
Rhode Island →
Office / nonfacility
Unavailable
Facility
$598.33
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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 27385 in Rhode Island.
PPRRVU2026_Oct_nonQPP.csv
2,864
- Code
- 27385
- Physician work
- 6.76
- Practice expense
- 9.49
- Malpractice
- 1.37
GPCI2026.csv
92
- Locality
- Rhode Island
- Physician work
- 1.019
- Practice expense
- 1.033
- Malpractice
- 0.892
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 6.76 | × 1.019 | 6.8884 |
| Practice expense | 9.49 | × 1.033 | 9.8032 |
| Malpractice | 1.37 | × 0.892 | 1.2220 |
| Total RVUs | 17.9136 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Rhode Island$598.33
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 6.76 | 1.019 |
| Practice expense | 9.49 | 1.033 |
| Malpractice | 1.37 | 0.892 |
(6.76 × 1.019 + 9.49 × 1.033 + 1.37 × 0.892) × $33.4009 = $598.33
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.
27385 billing questions
When should this code be chosen over 27386?
Use this code for direct repair of a torn or ruptured thigh muscle without a graft. Use 27386 when the repair uses graft material.
Is repair of the kneecap tendon reported here?
No. This code is for a thigh muscle; patellar tendon repair is reported with the code that matches the tendon repair performed, such as 27380 or 27381.
What documentation supports the repair?
Document the injured thigh muscle, the tear or rupture, the operative repair, and whether graft material was used.
How does the 90-day global period affect postoperative care?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
How is bilateral repair handled?
When the procedure is performed bilaterally, modifier 50 is paid at 150% under the CMS rule supplied for this code.
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.
2,86127372,,Removal of foreign body,A,,5.08,12.98,,5.57,,1.07,19.13,11.72,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,86227380,,Repair of kneecap tendon,A,,7.26,9.14,NA,9.14,,1.50,17.90,17.90,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,86327381,,Repair/graft kneecap tendon,A,,10.49,10.53,NA,10.53,,2.19,23.21,23.21,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,86427385,,Repair of thigh muscle,A,,6.76,9.49,NA,9.49,,1.37,17.62,17.62,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,86527386,,Repair/graft of thigh muscle,A,,10.85,11.10,NA,11.10,,2.22,24.17,24.17,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,86627390,,Incision of thigh tendon,A,,5.39,6.16,NA,6.16,,1.05,12.60,12.60,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,86727391,,Incision of thigh tendons,A,,7.30,7.70,NA,7.70,,1.52,16.52,16.52,0,090,0.10,0.69,0.21,2,0,0,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
8912502,PA,01,METROPOLITAN PHILADELPHIA,1.018,1.041,1.193
9012502,PA,99,REST OF PENNSYLVANIA,1.000,0.918,0.945
9109202,PR,20,PUERTO RICO,1.000,1.011,0.985
9214412,RI,01,RHODE ISLAND,1.019,1.033,0.892
9311202,SC,01,SOUTH CAROLINA,1.000,0.924,0.850
9403402,SD,02,SOUTH DAKOTA**,1.000,1.000,0.336
9510312,TN,35,TENNESSEE,1.000,0.909,0.537