Percutaneous tenotomy of the Achilles tendon performed under local anesthesia, in which tendon fibers are divided through small punctures to release contracture or correct deformity.

Verified May 8, 2026 · 7 sources ↓

Medicare: $337.02
Total RVUs: 10.09
Global, days: 10
Region: Foot & ankle

Drawn from CMSAAPCGenhealthCgsmedicareAbos

Documentation requirements

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

Source · Editorial brief grounded in 7 cited references ↓

Operative note must specify percutaneous technique — document the number and location of puncture sites, not just 'standard approach'
Confirm and document that local anesthesia (not general or regional block) was used; anesthesia type determines 27605 vs. 27606
Record the clinical indication: contracture severity, equinus angle measured pre- and intra-operatively, or specific diagnosis driving the release
If performed same-day with another foot or ankle procedure, document distinct site, distinct diagnosis, or distinct surgical objective justifying a separate service
Laterality must be specified (left, right, or bilateral) in both the operative note and the claim

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 LT Left side RT Right side XS Separate structure

What this code covers

Source · Editorial summary grounded in 7 cited references ↓

CPT 27605 covers a percutaneous Achilles tenotomy done under local anesthesia. The surgeon makes small punctures over the tendon — no large open incision — and uses a blade or specialized instrument to sever targeted fibers, reducing tension and correcting equinus deformity. Common indications include chronic Achilles contracture, congenital clubfoot correction, and spastic equinus from conditions such as cerebral palsy. The 'separate procedure' designation in the descriptor matters: when 27605 is performed as a standalone intervention, it bills at full value, but when performed as a component of a more extensive ankle or foot procedure, payers may bundle it unless modifier 59 (or XS) documents a distinct site or indication.

The code pairs with 27606, its sibling under general anesthesia — use 27605 only when local anesthesia is documented. Confusing this with 27685 (open tendon lengthening) or 27687 (gastrocnemius recession) is a common miscoding error that triggers downcoding or denial. The 10-day global period is short but real: any return for a related complication within those 10 days bills under modifier 78, not as a new 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	2.85
Practice expense RVU	6.96
Malpractice RVU	0.28
Total RVU	10.09
Medicare national rate	$337.02
Global period	10 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	$337.02
HOPD (APC 5112) Hospital outpatient department	$1,642.82
ASC (PI A2) Ambulatory surgical center (freestanding)	$872.87

Common denial reasons

The recurring reasons claims for CPT 27605 get rejected.

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

Bundled into a primary foot or ankle procedure because 'separate procedure' status was not overcome with modifier 59 or XS and supporting documentation
Anesthesia type not documented, causing payer to question whether 27605 (local) or 27606 (general) was the correct code
Miscoded as 27685 (open tendon lengthening) or 27687 (gastrocnemius recession), triggering incorrect bundling denials with co-submitted foot reconstruction codes
Laterality missing from the claim, resulting in edit-based rejection or suspended adjudication
Global period overlap: a related return procedure within the 10-day global submitted without modifier 78, denied as included service

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 7 cited references ↓

01What is the difference between 27605 and 27606?

The only distinction is anesthesia type. CPT 27605 requires local anesthesia; 27606 covers the identical percutaneous Achilles tenotomy performed under general anesthesia. Document anesthesia type explicitly — payers will downcode or deny if it's ambiguous.

02Can I bill 27605 with a foot reconstruction code like 28238 on the same date?

Yes, but you must append modifier 59 (or XS if the site is distinct) to 27605 and document a separate indication or operative site. Without it, payers routinely bundle the tenotomy into the reconstruction. The NCCI PTP tool at cgsmedicare.com lets you check the specific edit pair before submitting.

03Does 27605 carry a global period?

Yes — 10-day global. All routine follow-up through day 10 is included. A return to the OR for a related complication in that window bills with modifier 78; an unrelated procedure by the same physician uses modifier 79.

04When does modifier 50 apply to 27605?

Bill modifier 50 when the percutaneous Achilles tenotomy is performed bilaterally in the same operative session. Some payers require bilateral claims on a single line with modifier 50; others want two lines with LT and RT. Check payer-specific billing rules before submitting.

05Is 27605 appropriate for clubfoot correction in pediatric patients?

Yes. Percutaneous Achilles tenotomy is a standard component of Ponseti-method clubfoot treatment. Bill 27605 when the tenotomy is performed under local anesthesia, typically in an office or clinic setting. Document the diagnosis (congenital talipes equinovarus, Q66.0x) and the specific role of the tenotomy in the treatment sequence.

06Why would 27605 get denied as 'incidental' when billed with other ankle procedures?

The 'separate procedure' language in the descriptor signals to payers that the tenotomy may be considered a component of a more comprehensive ankle operation. Counter this by appending modifier 59 or XS and documenting a distinct surgical objective — different deformity, different anatomic site, or independent medical necessity beyond what the primary procedure addresses.

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 percutaneous technique, anesthesia type (local), puncture site locations, equinus angle correction, and clinical indication — the exact fields auditors check first on 27605 claims. This prevents the two most common denials: wrong code selection (27605 vs. 27606) due to missing anesthesia documentation, and bundling into a co-submitted procedure due to absent distinction language.

See how Mira captures CPT 27605 documentation