No office rate
This code concerns repair of a lower-leg flexor tendon. Choose the fascia repair code when the repaired structure is the fascial layer rather than the tendon.
On this page
CMS RVU26D · Effective 2026-10-01
27656 Fascia repair Medicare reimbursement rates in Utah
Surgical repair of a defect in lower-leg fascia, such as a symptomatic muscle herniation through the fascial layer. Compare 27656 office and facility rates across CMS payment localities in Utah.
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 27656 in Utah?
Utah 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
$508.18
1 of 1 localities have a supported rate.
Payment area: Utah
One mapped payment locality.
Facility setting
$310.07
1 of 1 localities have a supported rate.
Payment area: Utah
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 27656: Lower-leg fascial defect repair
Surgical repair of a defect in lower-leg fascia, such as a symptomatic muscle herniation through the fascial layer.
This service repairs a gap in the lower-leg fascia, the connective tissue covering the muscles. A familiar clinical situation is a symptomatic muscle herniation that protrudes through a fascial defect. An orthopedic surgeon or another surgeon treating lower-leg soft-tissue conditions may perform the repair in an operating room or ambulatory surgery setting. The operative report should identify the defect’s location and describe the fascial repair performed.
Report this code for the fascia repair itself, not for repair of an Achilles, flexor, or extensor tendon. CMS assigns a 90-day global period: the day-before preoperative visit and related postoperative care during the 90 days are included. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple-procedure reduction. For bilateral reporting with modifier 50, CMS pays at 150%. Assistant-at-surgery services may be paid; co-surgeons and team surgery are not permitted.
CMS billing rules for 27656
- 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 not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU4.59 · 29%
- Practice expense (office) RVU10.72 · 67%
- Malpractice RVU0.61 · 4%
200
Medicare services in 2024 · #4327 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.
27656 compared with similar codes
Office rates for Utah, from the same CMS release.
No office rate
This code concerns repair of a lower-leg extensor tendon. A fascial defect repair is distinct from repair of an injured extensor tendon.
No office rate
This code is for primary repair of a ruptured Achilles tendon. It does not describe repair of the surrounding lower-leg fascia.
Compare 27656 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
Utah →
Office / nonfacility
$508.18
Facility
$310.07
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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 27656 in Utah.
PPRRVU2026_Oct_nonQPP.csv
2,996
- Code
- 27656
- Physician work
- 4.59
- Practice expense
- 10.72
- Malpractice
- 0.61
GPCI2026.csv
104
- Locality
- Utah
- Physician work
- 1.000
- Practice expense
- 0.940
- Malpractice
- 0.898
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 4.59 | × 1.000 | 4.5900 |
| Practice expense | 10.72 | × 0.940 | 10.0768 |
| Malpractice | 0.61 | × 0.898 | 0.5478 |
| Total RVUs | 15.2146 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Utah$508.18
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 4.59 | 1 |
| Practice expense | 10.72 | 0.94 |
| Malpractice | 0.61 | 0.898 |
(4.59 × 1 + 10.72 × 0.94 + 0.61 × 0.898) × $33.4009 = $508.18
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 4.59 | 1 |
| Practice expense | 4.41 | 0.94 |
| Malpractice | 0.61 | 0.898 |
(4.59 × 1 + 4.41 × 0.94 + 0.61 × 0.898) × $33.4009 = $310.07
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.
27656 billing questions
How is this different from a lower-leg tendon repair code?
This service repairs the fascia surrounding the lower-leg muscles. Use a tendon repair code when the operative service repairs a flexor, extensor, or Achilles tendon.
What documentation supports reporting this service?
Document the lower-leg fascial defect, its location, and the repair performed. If muscle herniation prompted surgery, describe that finding and its relationship to the defect.
How does the 90-day global period affect postoperative billing?
The day-before preoperative visit and related postoperative care during the 90 days are included in the global period.
How is bilateral repair paid?
CMS identifies this as a bilateral procedure; when reported with modifier 50, payment is at 150%.
Can an assistant surgeon be reported?
CMS indicates that assistant-at-surgery services may be paid. Co-surgeons and team surgery are not permitted 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.
2,99327650,,Repair achilles tendon,A,,8.98,8.26,NA,8.26,,1.45,18.69,18.69,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,99427652,,Repair/graft achilles tendon,A,,10.51,6.56,NA,6.56,,1.39,18.46,18.46,0,090,0.10,0.69,0.21,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,99527654,,Repair of achilles tendon,A,,10.27,8.35,NA,8.35,,1.62,20.24,20.24,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,99627656,,Repair leg fascia defect,A,,4.59,10.72,,4.41,,0.61,15.92,9.61,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,99727658,,Repair of leg tendon each,A,,4.99,4.94,NA,4.94,,0.76,10.69,10.69,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,99827659,,Repair of leg tendon each,A,,6.92,5.46,NA,5.46,,0.99,13.37,13.37,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,99927664,,Repair of leg tendon each,A,,4.61,4.98,NA,4.98,,0.71,10.30,10.30,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
10104412,TX,15,GALVESTON,1.008,0.993,0.828
10204412,TX,18,HOUSTON,1.008,0.993,1.376
10304412,TX,99,REST OF TEXAS,1.000,0.949,0.903
10403502,UT,09,UTAH,1.000,0.940,0.898
10514512,VT,50,VERMONT,1.000,0.990,0.506
10611302,VA,00,VIRGINIA,1.000,0.983,0.706
10709202,VI,50,VIRGIN ISLANDS,1.000,1.011,0.985