Billing code 27685: Tendon lengtheningMedicare rate & RVUs in Washington
Reports surgical lengthening or shortening of one tendon in the leg or ankle, such as tendon length adjustment for a fixed deformity.
Medicare pays $700.16–$785.32 for 27685 in the office in Washington, from Rest Of Washington to Seattle (King Cnty). Which amount applies depends on the service address.
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 27685 covers
An orthopedic or podiatric surgeon surgically lengthens or shortens one tendon in the leg or ankle to change its effective length. A familiar example is lengthening the Achilles tendon to address a fixed ankle or foot deformity associated with tendon contracture. The procedure is generally performed in an operating room or ambulatory surgery setting.
Select this code when the operative work changes the length of a single tendon; document the tendon treated, the side, the reason for changing its length, and the technique performed. For each additional tendon treated, 27686 is the related add-on code rather than another unit of 27685. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and other procedures are reduced to 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be allowed; 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 27685 pays more and less in Washington
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Washington | $700.16 | $449.39 |
| Seattle (King Cnty) | $785.32 | $493.11 |
How the 27685 rate is calculated
Each of 27685’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 · 27685
RVUs × geographic indexes × conversion factor
Work6.52
6.52 RVUs× 1.000 GPCI
Practice expense12.97
12.97 RVUs× 1.000 GPCI
Malpractice0.92
0.92 RVUs× 1.000 GPCI
Adjusted RVUs
20.4100
Conversion factor
$33.4009
Medicare rate
$681.71
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 27685
27685 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 27685
Tendon lengthening
| 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 · 27685
Tendon lengthening
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
27685 without 50 · national office
$681.71
Tendon lengthening
27685-50 · Bilateral: 150%
$1,022.57
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).
27685 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 27686Tendon adjustment
- 27685 covers length adjustment of one tendon; 27686 is reported for each additional tendon treated.
- 27687Calf tendon revision
- 27687 describes gastrocnemius recession. Use it when the operative target is the gastrocnemius rather than length adjustment of a single leg or ankle tendon.
- 27680Tendon release
- 27680 releases adhesions around a tendon to improve glide. It is not the code for surgically lengthening or shortening that tendon.
- 27690Tendon transfer
- 27690 describes transfer of a superficial tendon to redirect its function; 27685 changes a tendon’s length without describing a transfer.
27685 billing questions
When should 27685 be selected instead of 27686?
Use 27685 for the first tendon whose length is changed. Report 27686 for each additional tendon treated in the same operative session.
Does this code describe tendon repair?
No. It describes surgically changing a tendon’s length. A repair code is considered when the operative work restores a torn or disrupted tendon rather than lengthening or shortening it.
What documentation supports reporting 27685?
The operative report should identify the tendon and side, the clinical reason for changing its length, and the lengthening or shortening work performed.
How is bilateral 27685 reported?
For bilateral procedures, report modifier 50. CMS pays the bilateral procedure at 150%.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be allowed. 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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