Open surgical division of one or more abductor and/or extensor tendons of the hip to relieve contracture, deformity, or spasticity.

Verified May 8, 2026 · 6 sources ↓

Medicare: $652.65
Total RVUs: 19.54
Global, days: 90
Region: Hip

Drawn from CMSNIHAAPCEmedny

Documentation requirements

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

Source · Editorial brief grounded in 6 cited references ↓

Identify the specific tendon(s) released — gluteus medius, gluteus maximus, tensor fascia lata, or other abductor/extensor — by anatomic name, not just 'hip tendons'.
State that the approach was open (skin incision, direct tendon visualization) to differentiate from percutaneous techniques billed under different codes.
Document the clinical indication: contracture, spasticity, deformity, or failed conservative treatment, with supporting diagnosis code(s).
Record laterality explicitly (left, right, or bilateral) in both the operative note and the procedure order.
Note anesthesia type used, as this affects medical necessity and facility-level billing.
Describe post-procedure plan — bracing, weight-bearing restrictions, physical therapy referral — to support medical necessity and global period management.

Applicable modifiers

Modifiers commonly billed with this code.

Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual

22 Increased complexity 50 Bilateral procedure 51 Multiple procedures 58 Staged or related 59 Distinct service 78 Unplanned return — related 79 Unrelated during global 80 Assistant surgeon 24 Unrelated E/M during global LT Left side RT Right side XS Separate structure

What this code covers

Source · Editorial summary grounded in 6 cited references ↓

CPT 27006 covers an open tenotomy of the hip abductor and/or extensor tendons — a procedure where the surgeon makes a skin incision, isolates the target tendon(s) controlling hip abduction or extension, and divides them to release abnormal tension. This is distinct from percutaneous adductor tenotomy (27000) and open adductor tenotomy (27001), which target different muscle groups. The "separate procedure" designation in the descriptor means that when 27006 is performed as part of a larger surgical session, it may be bundled unless documented as a distinctly separate service at a different anatomic site or encounter.

The 90-day global period means all routine postoperative care — wound checks, dressing changes, suture removal, and related E&M visits — is bundled through day 90. Any E&M service during the global period unrelated to the tenotomy requires modifier 24. A subsequent planned procedure during the global requires modifier 58; an unplanned return to the OR for a related complication requires modifier 78; an unrelated procedure during the global requires modifier 79. Bilateral hip tenotomy on the same date is reported with modifier 50, appended to a single line. Use LT or RT when only one side is treated and laterality must be specified for payer tracking.

RVU & reimbursement

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

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU	9.86
Practice expense RVU	8.2
Malpractice RVU	1.48
Total RVU	19.54
Medicare national rate	$652.65
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	$652.65
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 27006 get rejected.

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

Missing or vague laterality documentation causes payer-level claim edits and rejections when LT/RT modifiers are required.
Bundling denials when 27006 is billed same-session with overlapping hip incision or fasciotomy codes without modifier 59 or XS and supporting documentation of distinct anatomic sites.
Medical necessity denial when the operative note lacks documentation of failed conservative management (physical therapy, Botox, stretching) prior to surgical intervention.
Global period conflict when a related E&M visit is billed within the 90-day window without modifier 24, triggering automatic bundling by the payer.
Incorrect modifier usage — applying modifier 79 instead of 78 for an unplanned return to the OR for a tenotomy-related complication, or vice versa.

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 6 cited references ↓

01How does 27006 differ from 27001 and 27000?

27000 is a percutaneous adductor tenotomy; 27001 is an open adductor tenotomy. 27006 is an open tenotomy of the abductor and/or extensor muscles — a different muscle group and, in the case of 27006 vs. 27000, a different surgical approach. Don't interchange them based on incision size alone.

02Can 27006 be billed bilaterally on the same date?

Yes. Append modifier 50 to a single claim line when the open abductor/extensor tenotomy is performed on both hips in the same operative session. Medicare reimburses bilateral procedures at 150% of the single-side allowable. Confirm your payer follows this convention — some commercial payers require two separate lines with LT and RT instead.

03What does the 90-day global period include for 27006?

All routine postoperative care through day 90 is bundled: wound checks, dressing changes, suture removal, and related office visits. Bill modifier 24 on any E&M that is clearly unrelated to the tenotomy recovery. Document the unrelated complaint explicitly in the note to survive a payer audit.

04Is 27006 subject to NCCI bundling with fasciotomy codes?

Potentially yes. If a hip or thigh fasciotomy (e.g., 27025) is performed at the same anatomic site in the same session, NCCI edits may bundle 27006 as the column-2 code. If the procedures are genuinely distinct — different tendons, different incisions, separate anatomic sites — modifier 59 or XS with supporting operative note documentation is required to unbundle.

05What ICD-10 diagnoses most commonly support 27006?

Common supporting diagnoses include hip contracture (M24.55x), muscle spasticity (R25.2), and sequelae of cerebral palsy or other neurologic conditions causing hip deformity. The diagnosis must reflect the specific tendon or muscle group being released and must appear in the history and physical, not just the billing sheet.

06If a complication requires returning to the OR during the global, which modifier applies?

Modifier 78 — for an unplanned return to the OR for a procedure related to the original tenotomy (e.g., wound dehiscence requiring repair). Use modifier 79 only if the return-to-OR procedure is completely unrelated to the tenotomy. Inverting 78 and 79 is a common audit finding.

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 specific tendon(s) divided by anatomic name, the open approach, laterality, and the clinical indication from dictation — eliminating the vague operative note language ('hip tendons released') that triggers medical necessity and bundling denials on audit. It also flags when the note lacks documentation of prior conservative treatment, which is the most common medical necessity denial driver for this code.

See how Mira captures CPT 27006 documentation