Surgical release of a single flexor or extensor tendon in the leg or ankle to free it from scarring or adhesions restricting motion.

Verified May 8, 2026 · 7 sources ↓

Medicare: $408.49
Total RVUs: 12.23
Global, days: 90
Region: Foot & ankle

Drawn from CMSAAPCFindacodeAAOS

Documentation requirements

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

Source · Editorial brief grounded in 7 cited references ↓

Identify the specific tendon(s) released by name (e.g., tibialis anterior, flexor hallucis longus, peroneus brevis) — generic references to 'leg tendon' are an audit flag.
Describe the pathology justifying tenolysis: characterize the scar tissue or adhesions found intraoperatively, not just preoperative symptoms.
State the surgical approach used and confirm the tendon was intact at time of release, distinguishing tenolysis from repair.
If billing 27680 on the same claim as a tendon repair code, document that the tenolysis addressed a separate, distinct tendon with a separate pathologic process.
For bilateral procedures billed with LT/RT, document clinical necessity for each limb independently.
ICD-10 diagnosis must map specifically to adhesions, scarring, or acquired tendon restriction — not to an acute tear or rupture, which would point to a repair code.

Applicable modifiers

Modifiers commonly billed with this code.

Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual

22 Increased complexity 24 Unrelated E/M during global 25 Significant separate E/M 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 ↓

27680 covers tenolysis of a single flexor or extensor tendon in the leg or ankle — a procedure that frees a tendon bound down by scar tissue or adhesions, restoring glide and reducing pain. The tendon itself is intact; the problem is extrinsic restriction, not structural failure. That distinction matters for code selection: repair codes apply when the tendon is torn or ruptured; tenolysis applies when it's tethered.

The code is unit-based — one unit per tendon released. When multiple tendons are released in the same leg or ankle in the same session, report 27681 for multiple tendons rather than stacking 27680 units. If you legitimately bill 27680 twice for bilateral procedures (left and right limb), append LT and RT. The 90-day global period applies, so any related follow-up through day 90 is bundled. Unrelated E/M services in that window require modifier 24.

Bundling is the primary audit risk here. Per AAOS Global Service Data guidance, 27680 is included in certain higher-order tendon repair codes — notably when performed in conjunction with peroneal tendon repair (27675) or other reconstructive procedures. Bill it as a standalone or with modifier 59 only when the tenolysis addresses a distinct tendon not otherwise captured by the primary repair code, and document that distinction explicitly in the operative note.

RVU & reimbursement

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

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU	5.73
Practice expense RVU	5.54
Malpractice RVU	0.96
Total RVU	12.23
Medicare national rate	$408.49
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	$408.49
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 27680 get rejected.

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

Bundling denial when 27680 is billed alongside a primary tendon repair code without modifier 59 and documentation of a distinct tendon.
Upcoding flag when operative note doesn't name the specific tendon released, leaving auditors unable to confirm single vs. multiple tendon work.
Medical necessity denial when the diagnosis code reflects an acute tear rather than scarring or adhesive restriction, mismatching procedure to indication.
Global period denial for related E/M visits billed without modifier 24 within the 90-day post-op window.
Payer downcoding to 27681 or rejection when multiple units of 27680 are stacked instead of using the correct multiple-tendon code.

Frequently asked questions

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

01When should I use 27680 vs. 27681?

27680 is for a single tendon. If you release two or more tendons in the same leg or ankle during the same session, report 27681 instead. Don't stack multiple units of 27680 — that's incorrect coding and will draw a bundling edit.

02Can I bill 27680 with a tendon repair code on the same day?

Only if the tenolysis addresses a completely separate tendon from the one being repaired, with distinct pathology documented in the operative note. Append modifier 59 or XS and make the distinction explicit. Per AAOS Global Service Data, 27680 is included in certain repair codes when performed on the same tendon.

03What modifier applies when I perform tenolysis on both ankles in the same session?

Bill 27680-LT and 27680-RT on separate line items. Do not use modifier 50 unless your payer specifically requires bilateral billing on a single line — most orthopaedic payers prefer LT/RT on separate lines for this code.

04What ICD-10 codes support 27680?

Codes reflecting tendon adhesions, post-traumatic scarring, or acquired tendon restriction are appropriate — for example, M67 series (tendon disorders) or sequela codes from prior injury. Acute rupture or tear codes point to repair codes, not tenolysis.

05Does the 90-day global period mean I can't bill any visits after surgery?

Routine post-op visits related to the tenolysis are bundled through day 90. For unrelated problems, append modifier 24 to the E/M. For a new, distinct condition requiring a separate procedure in the global period, modifier 79 applies if unrelated or modifier 78 if returning to the OR for a complication of the original procedure.

06Is assistant surgeon reimbursement available for 27680?

Medicare recognizes assistant surgeon services for this code — bill with modifier 80 for an MD assistant or AS for a PA or NP assistant. Confirm the specific payer allows it; some commercial plans follow Medicare policy here, others require pre-authorization.

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 tendon name, the intraoperative description of scar tissue or adhesions, confirmation that the tendon was structurally intact at release, and the surgical approach from dictation. This prevents the most common audit trigger — an operative note that identifies a procedure without naming the specific tendon or characterizing the pathology, which auditors treat as insufficient to support 27680 over a lower-complexity code.

See how Mira captures CPT 27680 documentation