Summary & Overview
CPT 27393: Hamstring Tendon Lengthening, Single Tendon
CPT code 27393 represents a surgical tendon-lengthening procedure directed at a single hamstring tendon, performed by incising the tendon from knee toward hip. This code captures a targeted orthopedic intervention commonly used to address hamstring contractures, spasticity-related shortening, or functional limitations that impair gait and range of motion. Nationally, accurate coding for this procedure supports appropriate clinical documentation, care coordination, and claims adjudication in surgical and ambulatory settings.
Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of the clinical context for CPT code 27393, typical sites of service, common billing modifiers, and the payer mix relevant to national reimbursement and utilization discussions. The publication summarizes benchmarking considerations and policy updates that affect coverage and claims processing and provides clinical context to assist coding accuracy.
This summary is intended for healthcare administrators, coding professionals, and policy analysts seeking a concise briefing on the procedure captured by CPT code 27393, its placement within orthopedic surgical services, and the payer environment that influences billing and coverage nationally.
Billing Code Overview
CPT code 27393 describes a surgical procedure to lengthen a single hamstring tendon by making an incision along the tendon from the knee toward the hip. The hamstring group includes the biceps femoris, semitendinosus, and semimembranosus muscles, which contribute to knee flexion and hip extension.
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Service type: Surgical tendon lengthening of a hamstring muscle (orthopedic surgical procedure)
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Typical site of service: Hospital operating room or ambulatory surgery center
Clinical & Coding Specifications
Clinical Context
A 16-year-old adolescent with long-standing hamstring tightness limiting knee extension and causing gait disturbance presents for surgical lengthening of a single hamstring tendon. Conservative care including physical therapy, stretching, and orthotics failed to improve functional limitation and pain. Preoperative evaluation includes history and musculoskeletal exam confirming contracture of one hamstring component (eg, semitendinosus), imaging as indicated (plain radiographs or MRI if concern for associated pathology), informed consent, anesthesia evaluation, and preoperative marking of the affected limb. The procedure is performed in an operating room or ambulatory surgery center under general or regional anesthesia. The surgeon makes an incision over the tendon from knee toward thigh, isolates and lengthens the involved tendon to relieve contracture, achieves hemostasis, and closes the wound. Postoperative workflow includes short recovery in PACU, pain control, physical therapy initiation with a plan for progressive stretching and strengthening, wound check, and follow-up for range-of-motion assessment and return-to-activity planning. Typical sites of service are hospital outpatient surgery departments or freestanding ambulatory surgical centers for otherwise healthy patients; inpatient admission may occur for complex cases or when comorbidities require observation.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
LT | Left side | When procedure performed on the left lower extremity |
RT | Right side | When procedure performed on the right lower extremity |
50 | Bilateral procedure | When identical procedure is performed on both lower extremities in same operative session |
62 | Two surgeons | When two surgeons work together as primary surgeons throughout a single, complex procedure |
66 | Surgical team | When a surgical team provides services for the procedure |
22 | Increased procedural services | For substantially greater work, time, or difficulty than typical for the procedure — documented justification required |
52 | Reduced services | When the procedure is partially reduced or not completed as planned |
53 | Discontinued procedure | When procedure is started but discontinued due to unforeseen circumstances |
59 | Distinct procedural service | To indicate a separate and distinct procedure/service when multiple procedures on same day might be bundled |
76 | Repeat procedure by same physician | When the same procedure is repeated by the same physician subsequent to an earlier procedure on the same day |
77 | Repeat procedure by another physician | When a repeat procedure is performed by a different physician on same day |
78 | Unplanned return to OR | When patient returns to operating room for related procedure during global period due to a complication |
79 | Unrelated procedure or service | For unrelated procedure during global period (if applicable) |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
| 208100000X | Orthopedic Surgery | Orthopedic surgeons most commonly perform hamstring tendon lengthening |
| 2080P0220X | Pediatric Orthopedic Surgery | Pediatric orthopedists perform procedure for children/adolescents with congenital or developmental contractures |
| 2086S0102X | Physical Medicine & Rehabilitation | PM&R specialists coordinate pre- and postoperative rehab and may perform related procedures in some settings |
| 207L00000X | Sports Medicine (Orthopedics) | Sports medicine orthopedic specialists manage athletes with hamstring contractures and perform related surgeries |
| 2084P0800X | General Surgery (Lower Extremity) | Some general or vascular surgeons with appropriate training may be involved in complex lower-extremity procedures |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
M62.46 | Contracture of muscle, lower limb | Direct indication for tendon lengthening when contracture limits motion and function |
M24.2 | Disorder of ligament or joint — ankylosis, acquired | Associated stiffness or joint contracture that may coexist with hamstring tightness requiring surgical release |
M62.839 | Muscle spasm, other site | Severe, refractory muscle spasm of the hamstrings contributing to functional impairment |
M21.30 | Other acquired deformity, unspecified lower limb | Deformity related to muscle imbalance where tendon lengthening may correct alignment |
Q66.8 | Other congenital deformities of lower limb | Congenital contractures in children/adolescents sometimes treated with hamstring lengthening |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
20610 | Arthrocentesis, aspiration and/or injection; major joint or bursa (eg, hip, shoulder) | May be used preoperatively for diagnostic or therapeutic injections to assess pain generators or reduce inflammation before surgery |
20550 | Injection(s); single tendon sheath, or ligament, aponeurosis (eg, plantar "fascia") | Used for diagnostic or therapeutic injections of peri-tendinous structures as conservative management prior to considering tendon lengthening |
27096 | Fasciotomy, hip region; open | Performed when concomitant fascial release at hip is required for contracture that extends proximally and is not relieved by tendon lengthening alone |
29881 | Arthroscopy, knee, surgical; with meniscal repair | May be performed concurrently if intra-articular knee pathology is identified and requires treatment at same operative session |
27665 | Tenotomy, percutaneous, Achilles tendon | Represents analogous tendon-release procedures; may be billed in conjunction when multiple tendon procedures are performed on the same limb |
99024 | Postoperative follow-up visit, routine postoperative care | Used for routine postoperative global period visits to document recovery and rehabilitation progress |