Summary & Overview
CPT 27001: Open Tenotomy of Hip Adductor
CPT code 27001 represents an open tenotomy of the hip adductor, a surgical tendon division used to release adductor tightness or correct contracture. Nationally, this code is relevant for orthopedic and pediatric surgical practices, ambulatory surgical centers, and hospital operating suites because it denotes a discrete operative intervention with implications for operative planning, anesthesia, and post-operative rehabilitation.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of payer coverage considerations, typical sites of service, and clinical context for coding and billing. The publication provides benchmarks and payment context where available, summarizes common clinical indications and perioperative settings, and highlights areas of payer policy that commonly affect authorization and claims processing for surgical tendon procedures. Practical items covered include coding descriptors, expected care settings, and which payers commonly cover similar orthopedic tendon release procedures.
Data not available in the input for specific payment rates, associated taxonomies, and ICD-10 diagnosis pairings. The material is written for a national audience and focuses on clinical and billing context rather than state-specific rules.
Billing Code Overview
CPT code 27001 describes an open tenotomy of the adductor muscle of the hip, a surgical procedure in which the provider performs a division of one or more adductor tendons to release tightness or correct contracture. This procedure is a form of surgical tendon release focused on the hip adductor muscle group.
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Service type: Surgical procedure — open tenotomy of hip adductor
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Typical site of service: Operating room or ambulatory surgical center, performed by an orthopedic or pediatric orthopedic surgeon
Clinical & Coding Specifications
Clinical Context
A typical patient is an adolescent or adult presenting with persistent groin pain, limited hip adduction, or spasticity-related hip adductor contracture unresponsive to conservative care. Common scenarios include cerebral palsy with adductor spasticity causing scissoring gait, adductor tendon contracture after hip trauma, or chronic groin pain from adductor longus tendinopathy. Workflow: preoperative evaluation with history, focused hip and neurovascular exam, gait analysis if indicated, imaging such as hip radiographs or ultrasound to assess tendon pathology, and discussion of risks and benefits. On the day of service the patient undergoes preoperative anesthesia assessment, surgical site marking, and operative open tenotomy of the hip adductor tendon (CPT 27001) in an operating room or ambulatory surgery center. Postoperative care includes wound care, analgesia, physical therapy to maintain improved range of motion, and follow-up visits for suture removal and functional reassessment.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | For unusually extensive dissection or additional work documented during the open tenotomy |
50 |