Soft tissue repair · Knee

27380

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
Drawn from AAPCAbosCMSCgsmedicareEmedny

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 RVU7.26
Practice expense RVU9.14
Malpractice RVU1.5
Total RVU17.9
Medicare national rate$597.88
Global period90 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

SettingMedicare 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?
Timing and technique. 27380 is acute primary repair — suture of fresh tendon ends, typically within days of injury. 27381 is secondary reconstruction and includes obtaining and using a fascial or tendon graft. If your operative note describes a graft harvest or the repair is delayed weeks out, 27381 is correct.
02Can 27380 and 27381 ever be billed together?
No. They describe mutually exclusive approaches to the same tendon. Bill the one that matches what was actually performed. Upcoding to 27381 when only primary suture was done is an audit risk; downcoding to 27380 when a graft was used underpays the work.
03How do you bill 27380 when a patellar component is also removed during a prior TKA revision?
Code each distinct procedure separately. Patellar component removal from a prior TKA has its own code (e.g., 27488). Append modifier 51 to the secondary procedure and ensure the operative note documents separate indications and surgical steps for each.
04Is modifier 50 correct for bilateral patellar tendon repairs?
For professional claims, yes — append modifier 50 to a single line. For ASC facility claims, CMS instructs reporting on two separate lines with LT on one and RT on the other, each with one unit of service. Bilateral simultaneous patellar tendon ruptures are rare; document the clinical scenario thoroughly.
05What modifier applies if the patient returns to the OR within the global period for a wound complication related to the original repair?
Modifier 78 — unplanned return to the operating room for a procedure related to the original surgery within the global period. Do not use modifier 79 for related complications; 79 is reserved for procedures unrelated to the original surgery.
06Does the 90-day global period cover physical therapy and post-op bracing?
No. The global surgical package covers the surgeon's own post-op visits, not PT, DME, or other ancillary services. Those are billed separately by the respective providers. Only the operating surgeon's routine follow-up visits are bundled.
07When is modifier 22 appropriate for 27380?
When the repair required substantially more work than a typical infrapatellar tendon repair — for example, severely retracted or frayed tendon ends, an unusually complex reconstruction, or significant comorbidities that materially increased intraoperative difficulty. The operative note must explicitly describe the added complexity; a vague reference to 'difficult repair' will not survive audit.

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

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