Open surgical division of one or more hip flexor tendons, performed through a direct incision rather than endoscopically or percutaneously.
Verified May 8, 2026 · 5 sources ↓
- Medicare
- $674.03
- Total RVUs
- 20.18
- 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 5 cited references ↓
- Specify the approach as open with direct incision — not percutaneous or endoscopic.
- Name the specific tendon(s) released (e.g., iliopsoas, rectus femoris, sartorius).
- Document the clinical indication: spasticity, contracture, snapping hip, impingement, or other diagnosis driving the procedure.
- Record intraoperative findings including tendon condition, extent of release, and any associated pathology.
- Note whether the tenotomy was the primary procedure or performed alongside another hip procedure, and if so, the anatomic distinctness justifying separate billing.
- For post-op visits within the 90-day global, use modifier 24 for unrelated visits and document why the visit falls outside routine post-op care.
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 5 cited references ↓
CPT 27005 covers open tenotomy of the hip flexor muscles — most commonly the iliopsoas, but the code applies to any hip flexor tendon released via open approach. It carries a 90-day global period, meaning all routine post-op care through day 90 is bundled into the surgical payment. Bill unrelated E/M services in that window with modifier 24; bill a significant, separately identifiable E/M on the day of surgery with modifier 25.
Approach matters for code selection. If the surgeon releases the iliopsoas endoscopically or arthroscopically, 27005 does not apply — report 29999 (unlisted arthroscopy) instead, because no arthroscopic-specific code describes this release. Document clearly whether the approach was open, as payers and auditors will look for operative note language confirming direct incision and visualization.
The parenthetical "separate procedure" designation in the descriptor signals that 27005 is typically a standalone service. When performed as part of a larger, more complex hip procedure in the same operative session, it is bundled and not separately reportable unless it was performed at a distinct anatomic site or circumstance that justifies modifier 59 or XS. Run NCCI PTP edits before billing 27005 alongside any concomitant hip procedure.
RVU & reimbursement
Component RVUs and Medicare national rate. Actual payment varies by GPCI locality.
Source · CMS Physician Fee Schedule, RVU26A · January 2026
| Work RVU | 9.82 |
| Practice expense RVU | 8.35 |
| Malpractice RVU | 2.01 |
| Total RVU | 20.18 |
| Medicare national rate | $674.03 |
| 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 | $674.03 |
HOPD (APC 5113) Hospital outpatient department | $3,342.87 |
ASC (PI G2) Ambulatory surgical center (freestanding) | $1,644.87 |
Common denial reasons
The recurring reasons claims for CPT 27005 get rejected.
Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓
- Approach mismatch: arthroscopic or endoscopic release billed under 27005 instead of unlisted code 29999.
- Bundling with a concurrent major hip procedure without sufficient documentation supporting a distinct anatomic site or separate service.
- Missing or vague operative note — phrases like 'standard approach' or 'flexor released' without naming the tendon or confirming open access.
- Billing a routine post-op E/M within the 90-day global without modifier 24 and documentation that the visit is unrelated to the surgery.
- Diagnosis-to-procedure mismatch: ICD-10 code that does not support the clinical necessity of open hip flexor release.
Frequently asked questions
Source · Generated from the editorial pipeline, verified against 5 cited references ↓
01Can I bill 27005 for an arthroscopic or endoscopic iliopsoas release?
02What does the 'separate procedure' parenthetical mean for billing?
03If I perform open iliopsoas release at the same session as a total hip arthroplasty, can I bill both?
04What is the global period for 27005, and what does it include?
05Which ICD-10 codes most commonly support medical necessity for 27005?
06Is modifier 50 appropriate if the surgeon releases hip flexors bilaterally in the same session?
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/files/document/2025nccimedicarepolicymanualcompletepdf.pdf
- 03aapc.comhttps://www.aapc.com/codes/cpt-codes/27005
- 04vsac.nlm.nih.govhttps://vsac.nlm.nih.gov/context/cs/codesystem/CPT/version/2019/code/27005/info
- 05aapc.comhttps://www.aapc.com/codes/coding-newsletters/my-orthopedic-coding-alert/reader-questions-look-to-27005-for-illiopsoas-tendon-release-article
Mira AI Scribe
Mira's AI scribe captures the approach (open incision confirmed), the specific tendon(s) divided by name, the clinical indication, and intraoperative findings from dictation — then flags if the note contains vague language like 'flexor released' without anatomic specificity. This prevents the most common audit trigger for 27005: an operative note that fails to confirm open access and tendon identity, which payers use to downcode or deny the claim outright.
See how Mira captures CPT 27005 documentation