Surgical transfer of a paraspinal muscle to the hip region, using a fascial or tendon graft to restore function.

Verified May 8, 2026 · 6 sources ↓

Medicare: $812.64
Work RVU: 11.74
Global, days: 90
Region: Hip

Drawn from CMSAAPCAAOS

Documentation requirements

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

Source · Editorial brief grounded in 6 cited references ↓

Specify the donor paraspinal muscle transferred by anatomic name
Identify the graft material used (fascial graft, tendon graft, or other) and its harvest site
Document the recipient site attachment technique and fixation method
State the clinical indication — failed abductor reconstruction, post-resection deficit, congenital absence, or other cause — explicitly in the operative note
Record approach, patient positioning, and any intraoperative fluoroscopy used
Confirm pre-operative imaging or workup supporting the need for muscle transfer rather than simpler repair

Applicable modifiers

Modifiers commonly billed with this code.

Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual

22 Increased complexity 51 Multiple procedures 52 Reduced services 59 Distinct service 62 Co-surgeons 78 Unplanned return — related 79 Unrelated during global 80 Assistant surgeon LT Left side RT Right side

What this code covers

Source · Editorial summary grounded in 6 cited references ↓

CPT 27105 describes the operative transfer of a paraspinal (spinal) muscle to the hip, typically using a fascial or tendon graft to bridge the transferred tissue. This is a reconstructive procedure performed when primary hip abductor or stabilizer musculature is absent, deficient, or irreparably damaged — most commonly after failed prior surgery, tumor resection, or severe degenerative loss. The surgeon harvests and repositions the paraspinal muscle, secures it with graft material, and closes in layers. The reconstruction is technically demanding and carries a 90-day global period.

Because 27105 sits in the repair, revision, and reconstruction section for the pelvis and hip joint, payers expect operative notes that clearly describe the donor muscle, graft type, recipient site attachment, and the clinical indication driving the reconstruction rather than a simpler repair. Audit teams flag notes that describe the procedure generically without specifying those elements. If the transfer is performed in the same operative session as a resection (e.g., gluteal resection), bill the resection separately with modifier 51 appended to 27105.

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 (11.74) is the surgeon's own effort — the figure physician pay and productivity targets are built on. The total RVU (24.33) adds practice overhead and malpractice, and is what drives the Medicare payment below.

Work RVU	11.74
Practice expense RVU	10.09
Malpractice RVU	2.5
Total RVU	24.33
Medicare national rate	$812.64
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	$812.64
HOPD (APC 5113) Hospital outpatient department	$3,342.87
ASC (PI J8) Ambulatory surgical center (freestanding)	$2,386.26

Common denial reasons

The recurring reasons claims for CPT 27105 get rejected.

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

Operative note lacks specificity about donor muscle and graft type, triggering medical necessity denial
Bundling conflict when 27105 is billed same-day with a resection code without modifier 51
Missing or vague ICD-10 diagnosis that does not support the extent of reconstruction documented
Global period overlap — services billed within 90 days of a prior hip procedure without modifier 24 or 79

Frequently asked questions

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

01What is the global period for CPT 27105?

90 days. The global covers the surgery, the day-before visit, and all routine post-op care through day 90. Unrelated services billed during that window need modifier 79; unplanned returns for a related procedure need modifier 78.

02Can 27105 and a resection code be billed together on the same date?

Yes. If a gluteal or soft-tissue resection is performed in the same session, bill the resection separately and append modifier 51 to 27105 to indicate a second surgical procedure. Document each procedure distinctly in the operative report.

03Which ICD-10 codes most commonly support 27105?

Diagnoses that document an underlying structural or functional deficit at the hip — such as acquired absence of hip musculature following tumor resection, muscle weakness due to prior surgery, or congenital hip muscle deficiency — are expected. The ICD-10 must match the narrative in the operative and clinical notes.

04Is modifier 22 appropriate for 27105?

Yes, when the transfer is substantially more complex than typical — for example, extensive scarring from prior surgery, difficult graft harvest, or prolonged operative time. Attach a cover letter explaining the increased work; payers rarely pay modifier 22 upcharges without documentation.

05Where is 27105 typically performed, and does site of service affect payment?

27105 is performed in a hospital outpatient department or ASC. CMS 2026 payment rates differ between those sites — see the Site of Service comparison table on this page. The physician fee is the same regardless of site; the facility rate differs.

06Does 27105 require a specific approach to be documented?

The code does not specify approach by name, but audit reviewers flag operative notes that omit the surgical approach entirely. Document the approach (e.g., posterior, lateral) along with patient positioning and any adjunctive techniques used.

Sources & references

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

Mira Scribe

Mira's AI scribe captures the donor muscle name, graft source and type, recipient site attachment method, and the specific clinical indication (e.g., post-resection abductor deficit, failed prior repair) directly from dictation. That level of detail in the operative note is what separates a clean claim from a medical-necessity denial — payers reject 27105 claims that describe the procedure generically without naming the transferred muscle and explaining why simpler repair was not viable.

See how Mira captures CPT 27105 documentation