Summary & Overview
CPT 27394: Hamstring Tendon Lengthening, Unilateral
CPT code 27394 identifies a surgical hamstring tendon lengthening procedure performed on one leg, with incisions extending from the knee toward the hip to release and lengthen multiple hamstring tendons. The code captures a targeted orthopedic intervention intended to improve knee extension and reduce functional limitations caused by hamstring tightness or contracture. Nationally, this procedure is relevant for orthopedics and physical rehabilitation pathways and factors into coverage determinations and facility planning for operative musculoskeletal care.
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 CPT code 27394, a breakdown of typical sites of service and service type, and benchmarking and policy-oriented material where available. The publication highlights coding relationships, common modifier usage, and considerations for surgical billing workflows. It also summarizes where additional data is required and notes that specific diagnosis coding and payer-specific coverage criteria should be reviewed when preparing claims.
This brief aims to equip billing specialists, orthopedic clinicians, and policy analysts with the essential facts about CPT code 27394, helping them locate further details on reimbursement policy, clinical indications, and billing practice.
Billing Code Overview
CPT code 27394 describes a surgical procedure to lengthen multiple hamstring tendons in one leg by making incisions from the knee to the hip. The hamstring group includes the biceps femoris, semitendinosus, and semimembranosus muscles, which function to bend the knee and extend the thigh backward. The procedure directly addresses tightness, contracture, or other structural issues affecting hamstring length and knee mobility.
Service Type: Orthopedic surgical procedure — tendon lengthening of the hamstrings
Typical Site of Service: Hospital operating room or outpatient surgical center, depending on clinical setting and patient factors.
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A typical patient is an adolescent or adult with symptomatic hamstring contracture causing limited knee extension and functional impairment, often due to cerebral palsy, post-traumatic scarring, or longstanding muscle tightness. The patient presents to an orthopedic clinic with progressive difficulty walking, frequent falls, or persistent knee flexion deformity despite conservative measures (physical therapy, stretching, orthotics). Imaging and physical exam confirm tightness of the hamstring muscle group (biceps femoris, semitendinosus, semimembranosus) predominantly on one side.
Preoperative workflow includes evaluation by an orthopedic surgeon (often pediatric orthopedics or orthopedic spine/limb deformity specialist), gait analysis when indicated, informed consent discussing risks and benefits, and preoperative clearance. The procedure, coded as 27394, is typically performed in an operating room or ambulatory surgery center under general or regional anesthesia. Intraoperatively, the provider makes incisions to lengthen multiple hamstring tendons from knee to hip on one leg. Postoperative care includes pain control, wound care, early mobilization, physical therapy for stretching and strengthening, and scheduled follow-up to document functional improvement and monitor for complications such as infection or neurovascular injury.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
LT | Left side | When the procedure is performed on the left leg |
RT | Right side | When the procedure is performed on the right leg |
50 | Bilateral procedure | When the procedure is performed on both legs (bilateral) — use only if both sides were done in same operative session |
22 | Increased procedural services | When work, time, or complexity substantially exceeds typical for 27394 |
59 | Data not available in the input. | Data not available in the input. |
52 | Reduced services | When the service is partially reduced or not completed as described |
53 | Discontinued procedure | When the procedure is started but terminated due to extenuating circumstances |
62 | Two surgeons | When two surgeons work together as primary surgeons for distinct portions |
76 | Data not available in the input. | Data not available in the input. |
77 | Data not available in the input. | Data not available in the input. |
78 | Return to OR for related procedure during postoperative period | For unplanned return to operating room for a related procedure |
79 | Unrelated procedure or service by the same physician during postoperative period | For an unrelated procedure performed during the global period |
26 | Professional component | When only the professional component is billed separate from technical component (rare for this procedure) |
TC | Technical component | When only the technical component is billed separate from professional (rare for this procedure) |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
| 207X00000X | Orthopaedic Surgery | Primary specialty performing hamstring lengthening procedures |
| 2080S0001X | Orthopedic Surgery of the Spine | For deformity or neuromuscular cases involving gait/spine interaction |
| 208U00000X | Pediatric Orthopedics | Common when procedure is performed for cerebral palsy or pediatric contracture |
| 207L00000X | Sports Medicine | May perform hamstring procedures in adult athletes for chronic contracture |
| 208000000X | Physical Medicine & Rehabilitation | Often provides perioperative nonoperative management and postoperative rehab |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
M62.40 | Muscle contracture, unspecified site | General code for muscle contracture when hamstring-specific code not documented |
M62.41 | Muscle contracture, thigh | Directly describes hamstring (thigh) contracture necessitating lengthening |
G80.9 | Cerebral palsy, unspecified | Neuromuscular condition commonly associated with hamstring contractures leading to surgical lengthening |
M24.3 | Contracture of joint | Describes contracture affecting knee joint motion due to tight hamstrings |
S79.912A | Strain of muscle, fascia and tendon of unspecified part of hip, initial encounter | Acute or chronic strain/scar that may lead to surgical intervention |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
27500 | Percutaneous fasciotomy, hamstring (separate code) | May be used for less extensive hamstring releases or as a preceding/minimally invasive alternative |
27506 | Tenotomy, hamstring; open | Alternative or adjunct when a single tendon requires open lengthening or release |
20610 | Arthrocentesis, aspiration and/or injection; major joint or bursa (e.g., knee) | May be performed preoperatively for diagnostic or therapeutic injection to evaluate pain contribution |
99024 | Postoperative follow-up visit (global period) | Used to report postoperative follow-up visits during the global period when separately billable by some payors |
97001 | Physical therapy evaluation | Commonly performed in the postoperative rehabilitation plan to document therapy needs |