Primary open suture repair of the infrapatellar (patellar) tendon performed within days of acute injury.
Verified May 8, 2026 · 7 sources ↓
- Medicare
- $597.88
- Total RVUs
- 17.9
- Global, days
- 90
- Region
- Knee
Documentation requirements
What must appear in the operative or office note to support the claim.
Source · Editorial brief grounded in 7 cited references ↓
- Date of injury and time elapsed from injury to surgery — establishes 'primary' repair eligibility vs. 27381
- Operative report naming the repair technique (end-to-end suture, bone tunnel fixation, augmentation method)
- Laterality documented explicitly — left, right, or bilateral — to support LT/RT modifier use
- Intraoperative findings including degree of tendon disruption, retraction, and tissue quality
- Any concurrent procedures performed in the same session, with distinct indications documented separately
- Pre-op diagnosis with supporting ICD-10 code matching infrapatellar tendon rupture or avulsion
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 7 cited references ↓
CPT 27380 covers primary open repair of the infrapatellar tendon — the structure running from the inferior pole of the patella to the tibial tubercle. 'Primary' is the critical word: this code applies when repair is performed acutely, typically within a few days of rupture, before tendon retraction and scarring complicate the anatomy. If reconstruction is delayed and requires a fascial or tendon graft, bill 27381 instead.
The 90-day global period means all routine follow-up, dressing changes, and post-op visits through day 90 are bundled. Anything outside routine recovery — a new injury, an unrelated procedure, or a staged planned return — requires the appropriate modifier to separate from the global. Billing a post-op E/M without modifier 24 in this window is a reliable denial.
Patella tendon repairs in the setting of prior total knee arthroplasty (TKA) generate frequent coding questions. When a patellar component is removed and the tendon repaired in the same session, each distinct procedure requires its own code with appropriate modifiers. Document the indication, timing from injury, repair technique (end-to-end suture, bone tunnel fixation, augmentation), and any intraoperative findings that increased complexity — particularly if modifier 22 is warranted.
RVU & reimbursement
Component RVUs and Medicare national rate. Actual payment varies by GPCI locality.
Source · CMS Physician Fee Schedule, RVU26A · January 2026
| Work RVU | 7.26 |
| Practice expense RVU | 9.14 |
| Malpractice RVU | 1.5 |
| Total RVU | 17.9 |
| Medicare national rate | $597.88 |
| 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 | $597.88 |
HOPD (APC 5114) Hospital outpatient department | $7,413.38 |
ASC (PI A2) Ambulatory surgical center (freestanding) | $3,695.53 |
Common denial reasons
The recurring reasons claims for CPT 27380 get rejected.
Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓
- Global period conflict — post-op E/M billed without modifier 24 within the 90-day window
- Code mismatch with 27381 — payer downcodes or denies when documentation suggests delayed or grafted reconstruction rather than acute primary repair
- Missing laterality modifier when payer requires LT or RT for unilateral knee procedures
- Bundling conflict when concurrent procedures are billed without modifier 59 or XS and NCCI edits apply
- Insufficient documentation to support 'primary' timing — operative note lacks injury date or time-from-injury
Frequently asked questions
Source · Generated from the editorial pipeline, verified against 7 cited references ↓
01What separates 27380 from 27381?
02Can 27380 and 27381 ever be billed together?
03How do you bill 27380 when a patellar component is also removed during a prior TKA revision?
04Is modifier 50 correct for bilateral patellar tendon repairs?
05What modifier applies if the patient returns to the OR within the global period for a wound complication related to the original repair?
06Does the 90-day global period cover physical therapy and post-op bracing?
07When is modifier 22 appropriate for 27380?
Sources & references
Editorial content was developed using the following public sources. Last verified May 8, 2026.
- 01aapc.comhttps://www.aapc.com/codes/cpt-codes/27380
- 02abos.orghttps://www.abos.org/wp-content/uploads/2019/12/sports-cpt-updated.pdf
- 03aapc.comhttps://www.aapc.com/blog/32895-coding-that-brings-you-to-your-knees/
- 04cms.govhttps://www.cms.gov/files/document/04-chapter4-ncci-medicare-policy-manual-2025finalcleanpdf.pdf
- 05cgsmedicare.comhttps://www.cgsmedicare.com/medicare_dynamic/j15/partb/ptpb/ptp.aspx
- 06emedny.orghttps://www.emedny.org/providermanuals/physician/pdfs/physician%20procedure%20codes%20sect5.pdf
- 07CMS Physician Fee Schedule 2026
Mira AI Scribe
Mira's AI scribe captures injury date, mechanism, tendon involvement (infrapatellar vs. quadriceps), repair technique, bone tunnel or suture anchor use, augmentation details, and laterality directly from dictation. This prevents the two most common denials on 27380: missing injury timing that distinguishes primary repair from secondary reconstruction, and absent laterality that triggers payer rejections requiring LT or RT.
See how Mira captures CPT 27380 documentation