Percutaneous tenotomy of the hip adductor muscle, performed through a small puncture rather than an open incision.

Verified May 8, 2026 · 5 sources ↓

Medicare: $362.40
Total RVUs: 10.85
Global, days: 90
Region: Hip

Drawn from CMSCgsmedicareAAOS

Documentation requirements

What must appear in the operative or office note to support the claim.

Source · Editorial brief grounded in 5 cited references ↓

Diagnosis driving the procedure — specify adductor spasticity, contracture, or groin pathology with ICD-10 code
Documentation of failed conservative treatment prior to surgical intervention
Operative note confirming percutaneous approach and specific tendon(s) divided
Laterality documented explicitly (left, right, or bilateral) to support LT, RT, or 50 modifier use
Post-operative plan and functional goals supporting medical necessity

Applicable modifiers

Modifiers commonly billed with this code.

Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual

22 Increased complexity 24 Unrelated E/M during global 25 Significant separate E/M 50 Bilateral procedure 51 Multiple procedures 52 Reduced services 58 Staged or related 59 Distinct service 62 Co-surgeons 78 Unplanned return — related 79 Unrelated during global LT Left side RT Right side

What this code covers

Source · Editorial summary grounded in 5 cited references ↓

CPT 27000 describes a percutaneous approach to cutting the adductor muscle tendon at the hip — used most often for adductor spasticity, hip contracture, or adductor-related groin pain that has failed conservative management. The percutaneous technique means no formal open incision; the surgeon introduces a blade or similar instrument through a skin puncture to divide the tendon. That distinguishes it from open adductor tenotomy and drives the lower resource intensity relative to open hip soft-tissue procedures.

The 90-day global period covers all routine post-op care through day 90. Any E/M visit for an unrelated problem during that window requires modifier 24. If a separate, distinct procedure is performed on the same date — say, an injection at a different anatomic site — modifier 59 or XS applies, with documentation confirming the distinct service. Sports Medicine, Physical Medicine and Rehabilitation, and Orthopedic Surgery account for the bulk of Medicare utilization under this code.

Site of service matters. The HOPD and ASC payment rates differ meaningfully; see the Site of Service comparison table on this page. When this procedure is performed bilaterally in a single session, modifier 50 applies and payers typically reimburse the second side at a reduced rate per their multiple-procedure payment rules.

RVU & reimbursement

Component RVUs and Medicare national rate. Actual payment varies by GPCI locality.

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU	5.6
Practice expense RVU	4.67
Malpractice RVU	0.58
Total RVU	10.85
Medicare national rate	$362.40
Global period	90 days

Payment by site of service

Medicare pays different rates by setting. HOPD typically pays substantially more than ASC for the same procedure.

Source · CMS OPPS Addendum B·ASC HCPCS payment rates·2026

Setting	Medicare rate (national)
Office (PFS non-facility) Procedure performed in physician's office	$362.40
HOPD (APC 5112) Hospital outpatient department	$1,642.82
ASC (PI A2) Ambulatory surgical center (freestanding)	$872.87

Common denial reasons

The recurring reasons claims for CPT 27000 get rejected.

Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓

Missing or inadequate conservative treatment failure documentation before surgery
Operative note describes open technique but 27000 (percutaneous) was billed
Laterality modifier absent when bilateral procedure was performed
E/M visit billed during 90-day global without modifier 24 to indicate unrelated condition
Medical necessity not established — diagnosis code does not clearly link to adductor pathology requiring surgical release

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 5 cited references ↓

01What distinguishes 27000 from an open adductor tenotomy?

27000 is strictly the percutaneous approach — tendon division through a skin puncture without formal incision. Open adductor tenotomy is coded separately. Billing 27000 when the operative note describes an open incision is a coding mismatch that invites audit and downcode.

02How do I bill 27000 when the procedure is done bilaterally in the same session?

Append modifier 50 to 27000. Most commercial and Medicare payers reimburse the second side at 50% of the allowable. Confirm laterality is documented in the operative note — 'bilateral adductor tenotomy' must appear explicitly.

03Can I bill an E/M visit on the same day as 27000?

Yes, if the visit represents a separately identifiable, significant evaluation beyond the pre-procedure assessment. Append modifier 25 to the E/M. Document the medical decision-making as distinct from the procedure itself.

04Does the 90-day global period affect how I bill post-op injections at the hip?

Routine post-op care is bundled into the global. A therapeutic injection at a distinct anatomic site or for an unrelated condition can be billed separately with modifier 79 (unrelated procedure in global period) or 59/XS if same-day and distinct. Document the clinical rationale clearly.

05What ICD-10 codes most commonly support medical necessity for 27000?

M67.x series (contracture of tendon) and M62.4x (contracture of muscle) are the most common. Spasticity-related diagnoses (G80.x, G81.x, G82.x) support the procedure in neurologic populations. Pair the diagnosis to the operative indication in your documentation — generic 'hip pain' codes alone have a higher prior-auth and medical necessity denial rate.

06Is fluoroscopic or ultrasound guidance separately billable with 27000?

Only if the guidance is not described as integral to the procedure and is performed as a distinct service. Per NCCI general policy, if the code descriptor or CMS instruction indicates radiologic guidance is included, you cannot bill it separately. Verify current NCCI PTP edits for any imaging code you intend to add.

Sources & references

Editorial content was developed using the following public sources. Last verified May 8, 2026.

Mira AI Scribe

Mira's AI scribe captures the percutaneous approach, the specific adductor tendon(s) divided, laterality, and the failure of prior conservative management — all from dictation. That prevents the two most common audit flags: an operative note that omits the percutaneous technique (triggering a code-level mismatch) and a missing conservative-care narrative that carriers use to deny medical necessity on the front end.

See how Mira captures CPT 27000 documentation