Surgical repair of dislocating peroneal tendons at the ankle without fibular osteotomy — the tendons are repositioned and secured in place to prevent recurrent subluxation.

Verified May 8, 2026 · 5 sources ↓

Medicare: $469.28
Total RVUs: 14.05
Global, days: 90
Region: Foot & ankle

Drawn from AAPCPayerpriceGenhealthCMS

Documentation requirements

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

Source · Editorial brief grounded in 5 cited references ↓

Specify that no fibular osteotomy was performed — the presence or absence of osteotomy determines 27675 vs. 27676
Document the mechanism and degree of peroneal tendon instability, including retinaculum status (torn, attenuated, or avulsed)
Record laterality explicitly in both the operative note header and the procedure description
Describe the stabilization technique used — suture repair, retinaculum reconstruction, groove deepening — with sufficient detail to distinguish from tenolysis
Include pre-operative imaging (MRI or ultrasound) findings confirming peroneal tendon dislocation or superior peroneal retinaculum disruption
If billing additional same-session tendon procedures, document each as a separate, distinct surgical step with independent medical necessity

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 76 Repeat, same physician 78 Unplanned return — related 79 Unrelated during global LT Left side RT Right side

What this code covers

Source · Editorial summary grounded in 5 cited references ↓

CPT 27675 covers open repair of dislocating peroneal tendons where the surgeon repositions the subluxed tendons posterior to the lateral malleolus and stabilizes them — typically using sutures, retinaculum reconstruction, or groove deepening — without performing a fibular osteotomy. The procedure addresses peroneal tendon instability caused by superior peroneal retinaculum disruption, a condition commonly seen after ankle sprains or in patients with a shallow fibular groove. If the surgeon simultaneously performs a fibular osteotomy to deepen the groove, that work is captured under 27676 instead.

This code carries a 90-day global period. All routine follow-up within that window — wound checks, cast or boot changes, suture removal — is bundled. Bill separately only for distinct unrelated services (modifier 79) or complications requiring an unplanned return to the OR for a related procedure (modifier 78). Tenolysis (27680) and ankle tendon sheath procedures (27630) performed in the same session are considered bundled by the AAOS Global Service Data; unbundling those without strong medical necessity documentation and modifier 59 support is an audit risk.

The procedure is typically performed in an ASC or hospital outpatient setting. Laterality modifiers LT and RT are expected by most payers — omitting them on a unilateral procedure is a common clean-claim failure. If the repair is legitimately bilateral (rare), append modifier 50 and confirm payer policy, as some require separate line entries with LT/RT instead.

RVU & reimbursement

Component RVUs and Medicare national rate. Actual payment varies by GPCI locality.

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU	7.17
Practice expense RVU	5.81
Malpractice RVU	1.07
Total RVU	14.05
Medicare national rate	$469.28
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	$469.28
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 27675 get rejected.

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

Missing laterality modifier — payers reject claims for extremity procedures submitted without LT or RT
Bundling with 27680 or 27630 billed same-day without modifier 59 and supporting distinct medical necessity documentation
Diagnosis-procedure mismatch — submitting a non-specific ankle sprain ICD-10 rather than a code specific to peroneal tendon dislocation or retinaculum injury
Upcoding to 27676 when operative note does not document a fibular osteotomy, flagged on audit
Global period conflict — E/M or follow-up visit billed within the 90-day global without modifier 24 establishing an unrelated condition

Frequently asked questions

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

01What is the difference between 27675 and 27676?

27675 is repair of dislocating peroneal tendons without fibular osteotomy. 27676 includes the osteotomy to deepen the fibular groove. The operative note must explicitly state whether an osteotomy was or was not performed — that single distinction drives the code selection.

02Can 27675 and 27680 be billed together?

Generally no. The AAOS Global Service Data treats tenolysis (27680) as included in a peroneal tendon repair performed at the same operative session. Billing both requires modifier 59 and documentation that the tenolysis addressed a distinct tendon at a separate anatomic site with independent medical necessity — a high audit-risk combination.

03Is modifier 50 correct for bilateral peroneal tendon repair?

Bilateral peroneal tendon dislocation repair is uncommon, but if performed, modifier 50 is appropriate. Some payers require separate line items with LT and RT instead of a single line with 50 — check individual payer policy before submitting.

04What ICD-10 codes support 27675?

The strongest diagnosis support comes from codes specific to peroneal tendon dislocation or subluxation (M66.271/M66.272 for peroneal tendon spontaneous rupture with instability context, or S96.xx series for acute peroneal tendon injuries) and S93.xx for retinaculum disruption. Avoid submitting only a nonspecific ankle sprain code — that mismatch is a leading denial trigger.

05What does the 90-day global period cover for this procedure?

The global covers the surgery itself, the day-before pre-op visit, and all routine post-operative care through day 90 — wound checks, suture removal, boot or cast changes, and standard follow-up. Unrelated E/M services in that window need modifier 24. A return to the OR for a related complication (e.g., tendon re-dislocation) requires modifier 78.

06Does site of service affect reimbursement for 27675?

Yes. The HOPD and ASC facility payments differ substantially — see the Site of Service comparison on this page. The physician's professional fee (based on RVUs) is also lower when billed from a facility setting versus a non-facility setting, which is relevant if the practice owns an ASC.

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 absence of fibular osteotomy, the specific stabilization technique (retinaculum repair, groove deepening, suture anchors), and operative laterality directly from dictation — the three documentation elements that drive the 27675 vs. 27676 code selection and satisfy laterality edits in a single pass. That prevents the most common audit flag on peroneal tendon repairs: operative notes that confirm instability correction but don't explicitly exclude osteotomy or state a side.

See how Mira captures CPT 27675 documentation