Open surgical division of the hip adductor tendon to release contracture or spasticity
Verified May 8, 2026 · 6 sources ↓
- Medicare
- $514.04
- Work RVU
- 6.96
- Global, days
- 90
- Region
- Hip
Documentation requirements
What must appear in the operative or office note to support the claim.
Source · Editorial brief grounded in 6 cited references ↓
- Confirm and document open approach with formal incision — distinguish clearly from percutaneous technique
- Identify the specific adductor tendon(s) divided (adductor longus, brevis, gracilis, magnus) by name
- Record preoperative diagnosis with supporting clinical findings (contracture severity, range-of-motion deficits, spasticity grading)
- Document medical necessity: conservative treatment tried and failed, or functional limitation requiring surgical intervention
- Note laterality (left, right, or bilateral) explicitly in both the operative report and the procedure note
- If concurrent procedures performed, document each in a distinct section of the operative note to support separate billing
Applicable modifiers
Modifiers commonly billed with this code.
Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual
What this code covers
Source · Editorial summary grounded in 6 cited references ↓
CPT 27001 describes an open tenotomy of the adductor musculature of the hip — a direct surgical incision to divide the tendon, as opposed to the percutaneous approach captured by 27000. The open approach is chosen when the contracture is severe, when anatomy demands direct visualization, or when a concurrent procedure requires the same field. Common indications include spastic hip disease (cerebral palsy, acquired neuromuscular conditions), fixed adductor contractures limiting ambulation, and hip dysplasia-related deformity correction. The 90-day global period covers all routine post-op management, including wound care, early physical therapy supervision, and any related office visits through day 90.
The key coding distinction in this family is approach: 27000 is percutaneous (small stab incision, no direct tendon visualization), 27001 is open (formal incision with direct exposure). Billing 27001 when the operative note documents only a percutaneous technique is a common audit trigger. Document the incision length, specific tendon(s) divided, and intraoperative findings explicitly. If bilateral open adductor tenotomies are performed — common in pediatric spasticity cases — append modifier 50 and verify payer bilateral payment policy before submitting.
RVU & reimbursement
Component RVUs and Medicare national rate. Actual payment varies by GPCI locality.
Source · CMS Physician Fee Schedule, RVU26A · January 2026
Work RVU vs. total RVU
The work RVU (6.96) is the surgeon's own effort — the figure physician pay and productivity targets are built on. The total RVU (15.39) adds practice overhead and malpractice, and is what drives the Medicare payment below.
| Work RVU | 6.96 |
| Practice expense RVU | 6.96 |
| Malpractice RVU | 1.47 |
| Total RVU | 15.39 |
| Medicare national rate | $514.04 |
| 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 | $514.04 |
HOPD (APC 5113) Hospital outpatient department | $3,342.87 |
ASC (PI A2) Ambulatory surgical center (freestanding) | $1,644.87 |
Common denial reasons
The recurring reasons claims for CPT 27001 get rejected.
Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓
- Approach mismatch: operative note describes percutaneous technique but 27001 (open) was billed — should be 27000
- Lack of medical necessity documentation when conservative management history is absent from the record
- Missing laterality modifier (LT/RT) required by payer, especially on professional claims
- Bilateral procedures submitted without modifier 50 or without payer-required bilateral billing format
- Global period violation: related post-op services billed separately within the 90-day global without modifier 24 or 78
Frequently asked questions
Source · Generated from the editorial pipeline, verified against 6 cited references ↓
01What is the difference between 27000 and 27001?
02Can 27001 be billed bilaterally?
03What is the global period for 27001, and what does it include?
04Can 27001 be billed on the same day as a hip arthroscopy or other hip procedure?
05Which diagnoses most commonly support 27001 for Medicare?
06Is an arthroscopic iliopsoas lengthening reported with 27001?
Sources & references
Editorial content was developed using the following public sources. Last verified May 8, 2026.
- 01CMS Physician Fee Schedule 2026
- 02cms.govhttps://www.cms.gov/medicare/coding-billing/national-correct-coding-initiative-ncci-edits/medicare-ncci-faq-library
- 03aapc.comhttps://www.aapc.com/codes/cpt-codes/27001
- 04aapc.comhttps://www.aapc.com/codes/cpt-codes/27000
- 05medrxiv.orghttps://www.medrxiv.org/content/medrxiv/early/2025/02/13/2025.02.11.25322104/DC1/embed/media-1.docx
- 06aaos.orghttps://www.aaos.org/quality/resident-guide-to-coding-and-practice-management/coding-reimbursement-for-residents/coding-tools-for-residents/
Mira AI Scribe
Mira's AI scribe captures the surgical approach (open vs. percutaneous), incision details, specific tendons divided by anatomic name, laterality, and pre-op range-of-motion or spasticity findings from dictation. This prevents the most common 27001 denial — an operative note that reads as percutaneous when the open code was billed — and flags missing laterality before the claim is submitted.
See how Mira captures CPT 27001 documentation