Percutaneous tenotomy of multiple adductor or hamstring tendons in the thigh region

Verified May 8, 2026 · 5 sources ↓

Medicare: $376.09
Total RVUs: 11.26
Global, days: 90
Region: Knee

Drawn from CMSAbosAAOS

Documentation requirements

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

Source · Editorial brief grounded in 5 cited references ↓

Specify which tendons were released (adductor longus, brevis, magnus, gracilis, semimembranosus, semitendinosus, biceps femoris) — not just 'multiple tendons'
Confirm percutaneous approach is documented; open approach would require a different code
Document the clinical indication (e.g., spastic adductor contracture, hamstring contracture, neurologic diagnosis driving the procedure)
Record that more than one tendon was divided during the same operative session to distinguish from 27306
Note any intraoperative imaging guidance used and whether it was separately reportable or integral to the procedure
If modifier 22 is appended, document quantifiable reasons for increased complexity — procedure time, unusual patient anatomy, or severity of contracture

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 52 Reduced services 59 Distinct service LT Left side RT Right side 76 Repeat, same physician 77 Repeat, another physician 78 Unplanned return — related 79 Unrelated during global

What this code covers

Source · Editorial summary grounded in 5 cited references ↓

CPT 27307 describes a percutaneous tenotomy performed on multiple adductor or hamstring tendons. Unlike the open fasciotomy reported with 27305 or the single-tendon percutaneous tenotomy reported with 27306, this code requires that the surgeon cut through skin and release more than one tendon percutaneously during the same operative session. The 90-day global period applies, meaning routine follow-up through day 90 is bundled into the surgical payment.

Adductor tenotomy is performed most often in patients with spastic hip conditions, cerebral palsy, or severe adductor contracture. Hamstring tenotomy is similarly indicated in flexion contracture settings. When the clinical picture demands releasing multiple tendons rather than one, 27307 is the correct code — billing 27306 twice for the same encounter is unbundling and will trigger NCCI edits. If the procedure is more involved than typical (e.g., unusually severe contracture requiring significantly extended operative time), modifier 22 applies with supporting documentation.

Site of service matters here. HOPD and ASC facility payments differ substantially (see the Site of Service comparison table). The 90-day global covers the operative day, the day-before visit if applicable, and all routine post-op care through day 90. Anything unrelated billed in that window needs modifier 24 (E/M) or 79 (unrelated 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	5.91
Practice expense RVU	4.78
Malpractice RVU	0.57
Total RVU	11.26
Medicare national rate	$376.09
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	$376.09
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 27307 get rejected.

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

Billing 27306 twice for the same session instead of upgrading to 27307 — NCCI edits will bundle the duplicate
Operative note documents only one tendon released, contradicting the multiple-tendon requirement of 27307
Missing or inadequate clinical indication linking the diagnosis (ICD-10) to percutaneous multi-tendon release
Modifier 22 submitted without supporting documentation showing significantly increased operative time or complexity
Procedure billed with incorrect approach — open technique documented when percutaneous code was submitted

Frequently asked questions

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

01What is the difference between 27306 and 27307?

27306 covers percutaneous tenotomy of a single adductor or hamstring tendon. 27307 applies when two or more tendons are released percutaneously in the same session. Bill 27306 twice for the same encounter instead of 27307 and NCCI will bundle the second unit.

02Can I bill 27306 and 27307 together on the same claim?

No. 27307 already describes multiple tendons. Appending 27306 for an additional tendon on the same side at the same encounter is unbundling. If you released multiple tendons, 27307 is the single correct code.

03Does the 90-day global period reset if the patient needs an additional tendon released later?

Yes, if the subsequent release is a staged or related procedure by the same surgeon. Use modifier 58 to indicate a staged procedure and document the intent in the initial operative note. The global period resets from the date of the second procedure.

04When is modifier 22 justified for 27307?

Modifier 22 is justified when documented circumstances — severe contracture, unusual anatomy, significantly extended operative time — made the procedure substantially more work than typical. Attach a cover letter with operative time and a brief narrative. Payers will request the op note; have it ready.

05Is fluoroscopy or ultrasound guidance separately billable with 27307?

The CPT descriptor for 27307 does not include imaging guidance. If guidance was medically necessary and separately documented, it may be billable, but confirm payer policy — some payers consider it integral to percutaneous soft-tissue procedures. Per CMS NCCI policy, if the code descriptor already includes radiologic guidance, you cannot separately report it.

06Can 27307 be billed bilaterally?

Yes. If multiple tendons are released percutaneously on both sides in the same session, append modifier 50 for bilateral. Some payers require LT and RT on separate line items instead — verify your payer's preference before submitting.

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 names divided, confirms the percutaneous approach, and flags the operative count of tendons released from the surgeon's dictation. That prevents the most common audit failure on 27307 — notes that say 'multiple tendons' without naming them — which gives payers a straightforward basis to downcode to 27306.

See how Mira captures CPT 27307 documentation