Summary & Overview
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.
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. |