Surgical transfer or rerouting of each additional leg tendon beyond the first, reported as an add-on to the primary tendon transfer procedure.

Verified May 8, 2026 · 5 sources ↓

Medicare: $89.51
Work RVU: 1.82
Global, days
Region: Foot & ankle

Drawn from CMSAAPCGenhealth

Documentation requirements

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

Source · Editorial brief grounded in 5 cited references ↓

Identify each additional tendon by anatomic name (e.g., tibialis posterior, peroneus longus, extensor hallucis longus)
Describe the transfer technique for each tendon — rerouting path, new insertion site, fixation method
State the functional goal or deficit being addressed for each additional tendon transferred
Confirm the primary procedure code (e.g., 27690 or 27691) to which 27692 is linked as an add-on
Document the underlying diagnosis driving the need for multiple tendon transfers (e.g., equinovarus deformity, foot drop, spastic paresis)

Applicable modifiers

Modifiers commonly billed with this code.

Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual

22 Increased complexity 51 Multiple procedures 59 Distinct service 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 ↓

27692 is an add-on code for each additional tendon transferred, transplanted, or rerouted during the same operative session as the primary tendon transfer on the leg (tibia/fibula region). It is listed separately in addition to the primary procedure code — most commonly 27690 or 27691 — and is reported once per additional tendon addressed. Because it carries a ZZZ global period, it inherits the global period of the primary procedure to which it is linked.

This code appears most often in complex reconstructive settings: equinovarus deformity correction, foot drop reconstruction, peroneal nerve palsy cases, and spastic limb management where multiple tendons require simultaneous rerouting. Reporting it requires the operative note to clearly identify each tendon by name, the specific transfer technique used, and the distinct functional goal for each additional tendon — not just a generic reference to 'additional tendons transferred.'

Modifier 51 is not appended to add-on codes; NCCI rules preclude it. If the same surgeon performs an unrelated procedure during the postoperative period of the primary code, modifier 79 applies. Modifier 78 covers an unplanned return to the OR for a complication related to the original tendon transfer.

RVU & reimbursement

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

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU vs. total RVU

The work RVU (1.82) is the surgeon's own effort — the figure physician pay and productivity targets are built on. The total RVU (2.68) adds practice overhead and malpractice, and is what drives the Medicare payment below.

Work RVU	1.82
Practice expense RVU	0.51
Malpractice RVU	0.35
Total RVU	2.68
Medicare national rate	$89.51
Global period	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	$89.51

Common denial reasons

The recurring reasons claims for CPT 27692 get rejected.

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

Billed without a primary tendon transfer code — 27692 cannot stand alone as it is an add-on code
Operative note fails to individually identify and describe each additional tendon, leading to medical necessity denials
Modifier 51 incorrectly appended — add-on codes are exempt from multiple procedure reduction and modifier 51
Payer bundles 27692 into the primary tendon transfer code when documentation does not clearly distinguish separate tendon work
ICD-10 diagnosis does not support multiple tendon transfers (e.g., a single-tendon pathology billed with multiple add-on units)

Frequently asked questions

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

01How many times can 27692 be reported on the same date?

Once per additional tendon transferred beyond the primary procedure. If three tendons are addressed total, the primary code covers the first and 27692 is reported twice — once for each of the remaining two. Each unit must be supported by individual tendon-level documentation in the operative note.

02Which primary codes does 27692 pair with?

27692 is most commonly paired with 27690 (single tendon transfer, leg) or 27691 (complex tendon transfer with muscle redirection). The parenthetical instruction in CPT requires it to be listed in addition to the primary procedure code. Always confirm which primary code accurately reflects the complexity of the first tendon transfer before stacking 27692.

03Should modifier 51 be appended to 27692?

No. Add-on codes are exempt from modifier 51 and from the multiple procedure payment reduction. Appending modifier 51 to an add-on code is a common billing error that can trigger underpayment or a technical denial.

04What global period applies to 27692?

27692 carries a ZZZ global period, meaning it has no independent global period of its own. It inherits the global period of the primary procedure it accompanies — typically 90 days when paired with a major tendon transfer code.

05When is modifier 59 appropriate with 27692?

Modifier 59 is warranted only if NCCI edits bundle 27692 with another separately reported code and documentation supports a distinct service — different tendon, different anatomic site, or a procedure not integral to the primary transfer. Use it as a last resort after confirming no laterality or more specific modifier applies.

06Does 27692 have an HOPD or ASC facility payment rate?

No separate HOPD or ASC payment rate applies to 27692 as a standalone add-on. Facility reimbursement is bundled into the primary procedure's facility payment. Physician work RVUs are captured under the professional fee for each reported unit.

Sources & references

Editorial content was developed using the following public sources. Last verified May 8, 2026.

Mira Scribe

Mira's AI scribe captures each tendon transfer by name, rerouting path, new insertion site, and fixation technique from the surgeon's dictation — creating the tendon-level detail that payers require to pay each unit of 27692. Without that specificity, auditors bundle all additional tendon work into the primary code and deny the add-on charges.

See how Mira captures CPT 27692 documentation