Billing code 27664: Tendon repairMedicare rate & RVUs in Washington
Reports primary repair without a graft of an extensor tendon in the leg, such as a tibialis anterior tendon injury, counted for each tendon repaired.
CMS doesn’t publish an office rate for 27664 in Washington.
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 27664 covers
This code covers primary operative repair of an extensor tendon in the leg without a graft. A typical example is repair of a disrupted tibialis anterior tendon. Orthopedic and foot-and-ankle surgeons commonly perform the service in an operating room or other surgical setting. The code is specific to extensor tendons in the leg; Achilles tendon repairs and flexor tendon repairs have separate codes.
Report it for each tendon repaired, and document the tendon, the primary nature of the repair, and that no graft was used. The service has 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, the highest-valued procedure is paid in full and others are subject to the standard 50% reduction. Modifier 50 is inappropriate; the descriptor is reported for each tendon. Assistant-at-surgery payment requires documented medical necessity. Co-surgeons and team surgery are 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 27664 pays more and less in Washington
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Washington | Unavailable | $349.18 |
| Seattle (King Cnty) | Unavailable | $385.15 |
How the 27664 rate is calculated
Each of 27664’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 · 27664
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 4.61Practice expense 4.98Malpractice 0.71
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 27664
27664 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 27664
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) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| 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 · 27664
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
27664 without 51 · national facility
$344.03
Tendon repair
27664-51 · Second procedure: 50%
$172.02
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%).
27664 compared with similar codes
Compare codes
27664 vs 27665 vs 27650 vs 27652: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 27665Tendon repair
- Use 27664 for primary extensor tendon repair without graft; use 27665 for secondary extensor tendon repair without graft.
- 27650Achilles repair
- 27650 is specific to primary Achilles tendon repair without graft. Use 27664 for a primary extensor tendon repair elsewhere in the leg.
- 27652Achilles repair
- 27652 describes Achilles tendon repair with a graft. 27664 is for primary leg extensor tendon repair without a graft.
27664 billing questions
How does 27664 differ from 27665?
27664 is for primary repair of a leg extensor tendon without a graft. 27665 is the secondary-repair code for a leg extensor tendon without a graft.
Can 27664 be used for an Achilles tendon repair?
No. Achilles tendon repairs have dedicated codes, including 27650, 27652, and 27654, selected according to the repair performed.
How should multiple repaired tendons be reported?
The descriptor is per tendon, so identify each tendon repaired in the operative documentation and report the service accordingly. Modifier 50 is inappropriate.
What documentation supports primary repair?
Document the specific leg extensor tendon, the injury or disruption, and the operative repair performed. The record should support a primary repair without graft.
Can an assistant surgeon be reported?
Assistant-at-surgery payment is available only when medical necessity is documented. Co-surgeons and team surgery are not permitted for this code.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
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
Fee sheets
Put 27664 and the rest of your codes on one sheet
Build a fee sheet from your own code list at your locality, put your payer contracts beside Medicare, and see what changed each quarter.
Build my fee sheetOr price your code list free →