Billing code 27665: Tendon repairMedicare rate & RVUs in Texas
Reports secondary repair of an extensor tendon in the lower leg, with or without a graft, for each tendon treated.
CMS doesn’t publish an office rate for 27665 in Texas.
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 27665 covers
This code describes secondary repair of an extensor tendon in the lower leg, performed without a graft or with graft material when needed. It may be used for delayed or previously treated tendon injuries when the surgeon repairs an extensor tendon such as the tibialis anterior or a toe extensor. Orthopedic surgeons and foot and ankle surgeons typically perform the procedure in an operating room, often for chronic tendon disruption or a failed prior repair.
Report one unit for each tendon repaired, and document the specific tendon, the injury or prior repair, the secondary nature of the procedure, and whether graft material was used. Code 27664 is the primary-repair counterpart; code 27665 is not the code for a primary repair. 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 other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment may be available; 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 27665 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | Unavailable | $407.49 |
| Beaumont | Unavailable | $380.40 |
| Brazoria | Unavailable | $392.83 |
| Dallas | Unavailable | $396.22 |
| Fort Worth | Unavailable | $394.71 |
| Galveston | Unavailable | $394.60 |
| Houston | Unavailable | $410.53 |
| Rest Of Texas | Unavailable | $387.01 |
How the 27665 rate is calculated
Each of 27665’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 · 27665
RVUs × geographic indexes × conversion factor
Work5.43
5.43 RVUs× 1.000 GPCI
Practice expense5.66
5.66 RVUs× 1.000 GPCI
Malpractice0.87
0.87 RVUs× 1.000 GPCI
Adjusted RVUs
11.9600
Conversion factor
$33.4009
Medicare rate
$399.47
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 27665
27665 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 27665
Tendon 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) | 0 | The 150% bilateral adjustment doesn’t apply. |
| 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 · 27665
Tendon 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 51 · payment effect
With and without the modifier
27665 without 51 · national facility
$399.47
Tendon repair
27665-51 · Second procedure: 50%
$199.74
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
27665 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 27664Tendon repair
- Both address lower-leg extensor tendon repair, but 27664 is for primary repair without graft. Use 27665 for secondary repair, with or without graft.
- 27659Leg tendon repair
- 27659 is for secondary repair of a flexor tendon. Choose 27665 when the repaired tendon is an extensor tendon.
- 27654Achilles repair
- 27654 is a secondary repair code specific to the Achilles tendon. Use 27665 for secondary repair of another lower-leg extensor tendon.
27665 billing questions
How does 27665 differ from 27664?
27665 is for secondary repair of a lower-leg extensor tendon, with or without graft. Use 27664 for primary repair without graft.
Can 27665 be reported for a flexor tendon?
No. It applies to extensor tendons; codes 27658 and 27659 describe flexor tendon repair, with the primary or secondary distinction determining the applicable code.
How many units should be reported?
The code is reported for each tendon repaired. The operative report should identify each tendon treated.
Is the preoperative visit or routine postoperative care separately included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can modifier 50 be used when both legs are treated?
No. CMS indicates that bilateral adjustment does not apply and modifier 50 is inappropriate for this code.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be available. 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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