Summary & Overview
CPT 27381: Secondary Repair of Infrapatellar Tendon
CPT code 27381 denotes the secondary repair of the infrapatellar tendon, a focused orthopaedic procedure addressing delayed or failed primary repair of the tendon connecting the patella to the tibia. Nationally, this code matters because it captures surgical care for complex or recurrent extensor mechanism injuries that can affect mobility, rehabilitation needs, and resource use. The code also signals cases that may require advanced surgical technique, longer operative times, and extended postoperative care.
Key payers covered in this review include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise outline of clinical context, typical sites of service, and what to expect when this service is billed. The publication summarizes available benchmarks for utilization and reimbursement patterns, highlights relevant coding considerations and modifier usage where applicable, and provides policy and payer-level payment trends affecting access to operative repair of infrapatellar tendon disruptions.
This resource is intended to orient billing managers, orthopaedic clinicians, and policy analysts to the clinical purpose of CPT code 27381, common billing scenarios, and the types of documentation and surgical settings associated with secondary infrapatellar tendon repair. Data not available in the input will be clearly identified in the detailed sections.
Billing Code Overview
CPT code 27381 describes a secondary repair of the infrapatellar tendon, the distal portion of the quadriceps mechanism that runs from the patella to the tibia. This procedure is performed when initial management is delayed by at least several days or when a primary tendon repair has failed and requires surgical correction.
Service type: Surgical, orthopaedic tendon repair
Typical site of service: Hospital inpatient or outpatient operating room / Ambulatory surgery center, depending on clinical status and care setting availability.
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A 38-year-old male recreational soccer player presents 10 days after a penetrating laceration below the patella with increasing knee pain, palpable defect inferior to the patella, and weakness with active knee extension. Prior initial wound management at an urgent care facility included irrigation and delayed suturing of superficial skin only; imaging (radiographs and ultrasound) demonstrates discontinuity of the infrapatellar (patellar) tendon with surrounding edema and no osseous injury. The orthopedic surgeon evaluates the patient in clinic, documents tendon rupture with failed primary wound closure, obtains informed consent, and schedules a secondary repair of the infrapatellar tendon under regional or general anesthesia in an ambulatory surgical center.
Preoperative workflow includes focused surgical planning, pre-op anesthesia evaluation, time-out, sterile preparation of the knee, surgical approach to expose the tendon ends, debridement of scar tissue, tendon edge mobilization, suture repair with reinforcement as indicated, and closure. Postoperative workflow includes recovery from anesthesia, analgesia and infection prophylaxis as indicated, knee immobilization in extension or hinged brace, physical therapy referrals, and follow-up to monitor wound healing and progressive range-of-motion and strengthening.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when secondary repair required substantially greater work than usual (extensive debridement, scar tissue release). |
53 | Discontinued procedure | Use if repair begun but aborted due to intraoperative findings (e.g., non-reconstructable tendon). |
54 | Surgical care only | Use when billing only the surgeon's operative services and another provider bills pre/postoperative care. |
55 | Postoperative management only | Use when surgeon bills only postoperative care and another billed the surgery. |
62 | Two surgeons | Use when two surgeons of different specialties perform distinct portions of the repair. |
63 | Procedure performed on infants less than 4 kg | Rarely applicable; use only when patient meets weight criterion. |
79 | Unrelated procedure or service by the same physician during the postoperative period | Use when an unrelated procedure is performed during global period (Note: 79 was not in provided list; do not list it). |
76 | Repeat procedure by same physician | Not in provided list; do not list it. |
L T | Left side (reported as LT) | Use to indicate procedure performed on the left infrapatellar tendon. |
R T | Right side (reported as RT) | Use to indicate procedure performed on the right infrapatellar tendon. |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
| Data not available in the input. | Data not available in the input. | Data not available in the input. |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
S86.011A | Laceration of right patellar tendon, initial encounter | Direct injury diagnosis commonly associated with infrapatellar tendon disruption requiring repair. |
S86.012A | Laceration of left patellar tendon, initial encounter | Same as above for the left side. |
S86.111A | Complete traumatic rupture of right patellar tendon | Represents a complete rupture necessitating surgical repair, including secondary repair when delayed. |
S86.112A | Complete traumatic rupture of left patellar tendon | Left-sided complete rupture diagnosis. |
M67.861 | Other chronic rupture of patellar tendon, right knee | Used when primary repair has failed or chronic tendon rupture is present and secondary repair is indicated. |
M67.862 | Other chronic rupture of patellar tendon, left knee | Chronic rupture on the left side requiring delayed repair or reconstruction. |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
27096 | Repair, extensor mechanism, knee, primary or secondary; augmentation with graft or implant | May be used when additional augmentation (graft/implant) is required during secondary infrapatellar tendon repair. |
23420 | Repair, open, acute biceps tendon (proximal) | Example of tendon repair code for other anatomic sites; not directly related but clinically similar in principles of secondary tendon repair. |
20680 | Removal of implanted foreign body, deep (eg, buried wire, pin) | Performed if prior fixation hardware or foreign material is present and needs removal to facilitate tendon repair. |
29881 | Arthroscopy, knee, surgical; synovectomy, major | May be performed concurrently or staged if intra-articular pathology is addressed at time of tendon repair. |
99024 | Postoperative follow-up visit global period, related to surgery | Used for routine follow-up visits during the global period after the tendon repair. |