Summary & Overview
CPT 27390: Open Tenotomy of Single Hamstring Tendon
CPT code 27390 denotes an open tenotomy of a single hamstring tendon, a targeted surgical procedure used to divide or release one of the hamstring muscles (biceps femoris, semitendinosus, or semimembranosus) between the knee and hip. Nationally, this code captures discrete orthopedic tendon-release operations performed in operative settings and is relevant for hospitals, ambulatory surgery centers, and orthopedic surgical practices managing hamstring contractures, chronic tendinopathy, or select traumatic injuries.
Key payers included in this analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of clinical context for the service, typical sites of care, and common billing considerations tied to procedural coding. The publication summarizes benchmark elements and coding relationships where available and flags areas where input data are not provided.
The report covers clinical indications and operative scope implicit in the code, payer coverage scope at a national level, and practical coding context for revenue cycle teams and practice managers. It also outlines which additional elements are not present in the input (such as associated taxonomies, ICD-10 diagnoses, and related codes) so readers can identify gaps and plan for supplemental documentation or policy review.
Billing Code Overview
CPT code 27390 describes an open tenotomy of a single hamstring tendon, involving surgical division or cutting of any one of the hamstring muscles (biceps femoris, semitendinosus, or semimembranosus) along the thigh between the knee and hip. The procedure is focused on releasing or lengthening a single hamstring tendon to address conditions that impair knee flexion or thigh movement.
Service type: Surgical procedure — open tendon surgery (tenotomy)
Typical site of service: Hospital operating room or ambulatory surgery center, where open orthopedic tendon procedures are performed.
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult or adolescent presenting with chronic hamstring tightness, scarring, or tendon contracture after trauma, failed conservative care, or neuromuscular imbalance causing significant functional limitation, gait disturbance, or knee flexion impairment. The patient often reports posterior thigh pain, decreased hip extension, and difficulty with ambulation or athletic activity despite physical therapy, injections, and orthotic measures. Preoperative workup includes focused history and physical exam documenting range-of-motion deficits and focal tendon pathology, imaging as indicated (MRI or ultrasound of the posterior thigh), and discussion of surgical risks and expected outcomes.
In the clinical workflow, the patient is evaluated in an outpatient orthopedic or sports medicine clinic. Indications for an open hamstring tenotomy (CPT 27390) are confirmed and informed consent is obtained. The procedure is typically performed in an operating room or ambulatory surgery center under regional or general anesthesia. Preoperative antibiotics and standard sterile technique are used. The surgeon makes an open incision to identify and surgically divide the involved hamstring tendon (biceps femoris, semitendinosus, or semimembranosus) to relieve contracture or correct deformity. Postoperative care includes wound checks, pain control, physical therapy for range-of-motion and strengthening, and activity restrictions until healing and functional improvement are achieved.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
-11 | Normal procedure performed for the physician | Use when the procedure is the primary service performed without complications or unusual circumstances. |
-22 | Increased procedural services | Use when work required is substantially greater than typically required (extensive dissection, unexpected adhesions). |
-52 | Reduced services | Use when the procedure is partially reduced or not completed as planned. |
-53 | Discontinued procedure | Use when the procedure is terminated due to extenuating circumstances after induction of anesthesia. |
-62 | Two surgeons | Use when two surgeons of different specialties perform distinct parts of the procedure. |
-63 | Procedure performed on neonate, infant, or child | Use when age-specific reporting is required for pediatric patients. |
-66 | Surgical team (more than one surgeon) | Use when multiple surgeons function as a team and report team-surgery modifiers per payer rules. |
-79 | Unrelated procedure or service by the same physician during the postoperative period | Use when an unrelated procedure is performed during the global period. |
-80 | Assistant surgeon | Use when an assistant at surgery is required and documented. |
-RT | Right side | Use to indicate the procedure was performed on the right side. |
-LT | Left side | Use to indicate the procedure was performed on the left side. |
-AS | Physician assistant, nurse practitioner, or clinical nurse specialist services | Use when an advanced practice provider performs or assists per payer policy. |
-73 | Discontinued outpatient procedure prior to anesthesia date | Use when outpatient procedure is cancelled before anesthesia start. |
-26 | Professional component | Use if reporting only the professional component of a service when applicable (rare for this surgical code). |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
| 207L00000X | Orthopaedic Surgery | Primary specialty performing open hamstring tenotomy. |
| 2080P0227X | Sports Medicine (Physician) | Surgeons with sports medicine focus frequently perform this procedure for athletic injuries. |
| 208000000X | General Surgery | Some general surgeons with orthopedic training or in multidisciplinary centers may perform tendon procedures. |
| 2086S0126X | Physical Medicine & Rehabilitation | May be involved in pre/postoperative coordination and nonoperative management but do not usually perform the surgery. |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
M62.81 | Muscle weakness (generalized) | May be present when hamstring dysfunction contributes to gait impairment and functional limitation prompting tenotomy. |
M62.4 | Contracture of muscle | Direct indication when hamstring contracture limits range of motion and requires surgical release. |
S76.21XA | Strain of left hamstring muscle, initial encounter | Acute or chronic hamstring strains that progress to persistent tendon pathology may lead to surgical tenotomy. |
S76.22XA | Strain of right hamstring muscle, initial encounter | Side-specific acute/chronic strain relevant to surgical planning and modifier RT/LT. |
M24.2 | Disorder of ligament (instability) | Associated knee or hip joint instability can accompany hamstring pathology influencing surgical decision-making. |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
27395 | Tenotomy, percutaneous, hamstring (tendon sectioning) | Alternative, less invasive approach; may be performed in lieu of 27390 when appropriate. |
20610 | Arthrocentesis, aspiration and/or injection; major joint or bursa (eg, shoulder, hip, knee) | May be used preoperatively for diagnostic or therapeutic injection to differentiate tendon vs intra-articular pain. |
27096 | Excision of tumor or other lesion of muscle, fascia, or tendon (eg, hamstring) | Performed when a mass or adhesions require excision in addition to or instead of tenotomy. |
27079 | Muscle, tendon, or fascia procedures, not otherwise specified (unlisted pelvic/hip procedure) | Used if procedure performed has components not described by 27390 and additional documentation is required. |
99024 | Postoperative follow-up visit global period | Used for routine postoperative visits during the global period to report postoperative evaluation and management when payer requires explicit reporting. |