CPT 27098: Adductor Tendon Transfer to Ischium
CPT code 27098 denotes an orthopedic tendon transfer procedure in which adductor tendons are moved from their pubic origins to the ischium to alter hip muscle attachments and mechanics. This surgical code is relevant for complex hip reconstructive care, often performed for functional restoration or pain relief in patients with deformity, neuromuscular conditions, or chronic adductor pathology. Nationally, accurate coding of such reconstructive procedures affects quality measurement, facility case mix, and appropriate payment for specialized surgical care.
Key payers in the national landscape include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a clinical summary of the procedure, common sites of service, typical billing modifiers, and how this service maps to surgical orthopedic practice. The publication outlines coding context and practical considerations for documentation, and it highlights where to look for policy or coverage guidance from major payers. Data not available in the input is noted where applicable.
This brief provides clinicians, coding professionals, and policy analysts with a concise reference for CPT code 27098, its clinical role in hip reconstructive surgery, and the payer environment most relevant to claims and utilization discussions.
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Billing Code Overview
CPT code 27098 describes a surgical procedure in which the provider transfers the adductor tendons from their origin on the pubic bones to the ischium, the lowest part of the rear hip bone. The operation involves mobilizing one or more of the primary adductor muscles — adductor longus, adductor brevis, and gracilis — and reattaching their tendinous origins to the ischial tuberosity.
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Service type: Orthopedic reconstructive tendon transfer surgery
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Typical site of service: Inpatient or outpatient hospital surgical setting, or ambulatory surgical center
Clinical & Coding Specifications
Clinical Context
A typical patient is a 14–25 year-old athlete presenting with persistent medial thigh or groin pain, weakness, and recurrent adductor strains that have failed conservative management (physical therapy, activity modification, and injections). Clinical evaluation identifies chronic adductor tendinopathy with functional impairment and pelvic-floor or pubic-origin pain. Imaging (MRI or ultrasound) confirms pathological retraction or symptomatic avulsion/osis of the adductor origin on the pubic bone. The surgical workflow includes preoperative evaluation, anesthesia (general or regional), intraoperative identification and release of the adductor tendons from the pubic origin, mobilization and transfer of the tendons to the ischium, secure fixation of the transferred tendons, hemostasis, and layered wound closure. Postoperative care includes standardized analgesia, physical therapy initiated per protocol, and follow-up visits for wound check and rehabilitation progress. Typical site of service is an outpatient ambulatory surgical center or hospital operating room depending on comorbidities and anesthesia requirements. The service type is operative tendon transfer/reconstruction of the adductor muscle group (adductor longus, brevis, gracilis) to a new bony attachment at the ischium.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when work, time, or complexity is substantially greater than typical for 27098 and documentation supports increased work. |
52 | Reduced services | Use when the procedure is partially performed or not completed as planned but still reported. |
53 | Discontinued procedure | Use when the procedure is started but stopped due to extenuating circumstances or patient condition. |
59 | Distinct procedural service | Use to indicate a separate and distinct procedure from other services on the same day (e.g., an unrelated hip procedure). |
62 | Two surgeons | Use when two surgeons work together as primary surgeons performing distinct portions of 27098. |
66 | Surgical team | Use when a documented surgical team approach is employed for complex reconstruction. |
78 | Unplanned return to the OR | Use when the patient returns to the operating room for a related procedure during the postoperative global period. |
79 | (Not in provided list) | Data not available in the input. |
50 | Bilateral procedure | Use when 27098 is performed bilaterally; report according to payer bilateral rules. |
LT | Left side | Use to indicate procedure performed on the left side when laterality is required. |
RT | Right side | Use to indicate procedure performed on the right side when laterality is required. |
51 | Multiple procedures | Use when 27098 is one of multiple procedures performed at the same operative session. |
54 | Surgical care only | Use when the surgeon provides only the surgical portion and another practitioner provides pre/postoperative care. |
26 | Professional component | Use if billing only the professional interpretation/portion in situations with technical component split (rare for this procedure). |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
| 2080S0010X | Orthopaedic Surgery | Primary specialty performing adductor tendon transfer and hip/groin reconstructions. |
| 207L00000X | Sports Medicine (Orthopaedic) | Surgeons focusing on athletic hip injuries and tendon reconstructions. |
| 207X00000X | Surgery | General surgeons less commonly; included for completeness when performed by surgical specialists experienced in pelvic/hip reconstruction. |
| 207K00000X | Physical Medicine & Rehabilitation | Often involved in pre/postoperative rehabilitation planning but do not perform the surgical procedure. |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
M76.89 | Other enthesopathies of lower limb | Includes chronic tendinopathy at adductor origin causing groin pain and indicating surgical tendon transfer when conservative care fails. |
S73.4X0A | Strain of muscle, fascia and tendon of the hip, unspecified, initial encounter | Represents acute or chronic adductor strains that may progress to require surgical transfer. |
M24.2 | Disorder of ligament, not elsewhere classified | Used when chronic instability or connective tissue disorder contributes to adductor dysfunction. |
M67.9 | Disorder of synovium and tendon, unspecified | General tendon disorder code when specific tendinopathy code is not available. |
S33.4XXA | Sprain of ligaments of pubic symphysis and pelvis, initial encounter | Pelvic instability affecting adductor origin, clinically relevant to planning transfer. |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
27096 | Tendon transfer, thigh (other than adductor) | Performed for other thigh tendon transfers; similar technique and may be billed when other tendon groups are transferred in conjunction. |
27097 | Repair, tendon or ligament, hip region (intracapsular) | Used for repairs of hip region tendon/ligament pathology that may be performed alongside 27098 when additional repair is needed. |
27650 | Repair, ruptured Achilles tendon, primary, open | Example of a tendon repair code elsewhere; cited to illustrate tendon repair coding principles when multiple tendon sites are addressed (not typically performed with 27098). |
11042 | Debridement, muscle and/or fascia | May be performed if debridement of devitalized tissue at the adductor origin is required during the same operative session. |
20610 | Arthrocentesis, aspiration and/or injection; major joint or bursa | May be used preoperatively for diagnostic or therapeutic injections to localize pain prior to proceeding with 27098. |