Summary & Overview
CPT 27392: Open Tenotomy of Bilateral Hamstring Tendons
CPT code 27392 denotes an open tenotomy procedure that surgically divides multiple hamstring tendons across the thigh from knee to hip on both legs. This operative code is used for interventions addressing significant hamstring contractures, deformities, or other conditions requiring direct surgical release. Nationally, the code is relevant for surgical specialties managing lower-extremity musculoskeletal conditions and for payers overseeing coverage and surgical utilization.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical context for when 27392 is used, the typical surgical setting and service type, and an overview of billing considerations tied to bilateral open hamstring tenotomy. The publication summarizes available benchmarks and policy-relevant items where present and notes areas with limited input data.
This report provides clinicians, billing specialists, and policy analysts with practical clarity on the code's clinical scope, typical places of service, and the payer landscape addressed. Where detailed payer-specific rates, modifiers, or diagnosis mappings are not provided in the input, the report flags those elements as not available and focuses on the description and operational context necessary for clinical and administrative decision-making.
Billing Code Overview
CPT code 27392 describes an open tenotomy of the hamstring muscles, involving surgical division or cutting of multiple tendons of the hamstrings from the knee to the hip in both legs. The procedure targets the three major hamstring muscles: the biceps femoris, semitendinosus, and semimembranosus, which contribute to knee flexion and posterior thigh movement.
Service type: Surgical procedure — open tenotomy of bilateral hamstrings
Typical site of service: Inpatient or outpatient surgical setting (operating room), often in a hospital or ambulatory surgery center, depending on clinical complexity and patient needs.
Payers: Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A typical patient is a pediatric or adult patient with spasticity or fixed flexion deformity of the knees due to neuromuscular conditions (for example, cerebral palsy, spastic diplegia, or post-traumatic contracture) who presents with progressive difficulty standing, ambulating, or fitting orthoses. After multidisciplinary evaluation (orthopedics, physiatry, physical therapy), conservative measures such as stretching, botulinum toxin injections, and orthotic management have been attempted and found insufficient. The patient is scheduled for an open bilateral hamstring tenotomy to surgically lengthen or release multiple hamstring tendons (biceps femoris, semitendinosus, semimembranosus) from knee to hip to reduce knee flexion contracture and improve gait or seating.
The clinical workflow includes preoperative assessment and informed consent, preoperative anesthesia evaluation (general or regional anesthesia), positioning and sterile preparation in an operating room, surgical exposure and open division of the indicated hamstring tendons on one or both legs, hemostasis and closure, and immediate postoperative recovery with early physical therapy and outpatient or inpatient rehabilitation as indicated. Postoperative documentation will include laterality, number of tendons released, intraoperative findings, any complications, and discharge plan for rehabilitation and follow-up.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
50 | Bilateral procedure | Use when same procedure performed on both legs during the same operative session. |
LT | Left side | Use to indicate procedure performed on the left leg when billed unilaterally. |
RT | Right side | Use to indicate procedure performed on the right leg when billed unilaterally. |
22 | Increased procedural services | Use when work required is substantially greater than usual (document rationale). |
52 | Reduced services | Use when the procedure is partially reduced or not completed as described. |
53 | Discontinued procedure | Use when procedure is started but discontinued for reasons related to patient well-being. |
59 | Distinct procedural service | Use to indicate a separate and distinct procedure when multiple services on the same day might be bundled. |
62 | Two surgeons | Use when two surgeons with distinct surgical roles perform portions of the procedure. |
76 | Repeat procedure by same physician | Data not provided in input. Do not list. |
78 | Unplanned return to the operating room | Use when patient returns to OR for a related procedure during the postoperative period. |
79 | Unrelated procedure or service by the same physician during postoperative period | Data not provided in input. Do not list. |
56 | Preoperative assessment only | Use when surgeon performs pre-op evaluation but does not perform the procedure. |
23 | Unusual anesthesia | Use when procedure is performed under general anesthesia when local/monitored care is typical or patient has a contraindication to regional. |
63 | Procedure performed on infants younger than 4 kg | Use when patient meets weight criteria and service requires this modifier. |
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Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
M24.55 | Contracture, knee | Common indication when hamstring contracture limits extension and ambulation. |
G80.0 | Spastic quadriplegic cerebral palsy | Neuromuscular cause of severe lower-extremity spasticity that may necessitate hamstring release. |
G80.1 | Spastic diplegic cerebral palsy | Frequent indication in children with predominant lower-extremity spasticity and hamstring contractures. |
M62.81 | Muscle weakness (generalized) | May describe functional deficits contributing to gait abnormalities; used adjunctively. |
M21.69 | Other acquired deformity of limb | Used for acquired flexion deformities affecting knee/hamstring tension. |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
27130 | Arthroplasty, acetabular and proximal femoral prosthetic replacement (total hip arthroplasty) | Not commonly simultaneous with hamstring tenotomy but may be part of comprehensive management for hip-knee deformities in adults; listed as potential related lower-extremity orthopedic procedure. |
27540 | Repair, primary, traumatic rupture of skeletal muscle (e.g., hamstring) | May be used if tendon repair is required rather than release; represents alternative tendon procedure in same anatomic area. |
20550 | Injection(s); single tendon sheath, or ligament, aponeurosis (e.g., for diagnostic or therapeutic injections) | May be performed preoperatively for diagnostic or therapeutic management of spasticity or to assess response prior to tenotomy. |
64999 | Unlisted procedure, nervous system | May be used for peripheral nerve procedures performed adjunctively (note: unlisted codes require operative report). |
97001 | Physical therapy evaluation | Used in the postoperative rehabilitation phase for assessment and planning following tenotomy. |