Summary & Overview
CPT 27396: Thigh Muscle Tendon Transfer
CPT code 27396 covers surgical transfer or transplantation of a single thigh muscle tendon, a reconstructive orthopedic procedure used to restore or reassign muscle function (for example, converting an extensor to a flexor). This procedure matters nationally because it supports restoration of limb function after trauma, neurologic injury, or congenital deformity and can impact surgical utilization, post-operative rehabilitation pathways, and durable medical equipment needs.
Key payers included in the analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical purpose of the code, typical sites of service, and the types of benchmarking and policy-oriented information commonly associated with surgical procedure codes. The publication summarizes typical use cases, where this procedure is performed (inpatient, outpatient, ambulatory surgery centers), and the clinical context that commonly justifies billing the code.
The report also outlines what to expect in benchmarking and policy updates: national utilization patterns, coding clarifications that affect coverage determinations, and intersections with post-operative care and rehabilitation services. Data not provided in the input (such as specific payer policies, associated taxonomies, and ICD-10 pairings) are noted as unavailable and would be included in follow-up analyses.
Billing Code Overview
CPT code 27396 describes a surgical procedure in which a provider transfers or transplants a single muscle tendon in the thigh. The procedure repositions a tendon so that it can assume a new function—for example, transferring an extensor tendon to the flexor side so it functions as a flexor.
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Service type: Surgical tendon transfer or tendon transplantation of the thigh, reconstructive orthopedic procedure
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Typical site of service: Hospital inpatient or outpatient surgical setting, ambulatory surgery center, or specialized orthopedic surgery center
Data not available in the input for payers, associated taxonomies, ICD-10 diagnoses, and related codes.
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult with thigh muscle-tendon dysfunction after trauma or neurologic injury (for example, a femoral nerve palsy or post-traumatic loss of function) causing loss of active hip or knee motion. The patient presents with weakness or imbalance of thigh musculature and gait disturbance despite conservative measures (physical therapy, orthoses). Preoperative evaluation includes history, focused musculoskeletal and neurologic exam, imaging (plain radiographs, MRI or ultrasound of soft tissues as indicated), and documentation of failed nonoperative management. The surgical workflow: preoperative marking and consent, general or regional anesthesia, surgical exposure of the involved tendon in the anterior or posterior thigh, mobilization and release of the donor tendon, transfer or rerouting to the new insertion site on the flexor or extensor side, secure tendon fixation (sutures, bone tunnels or anchors), intraoperative testing of tension and range, irrigation and layered closure, postoperative immobilization or bracing, and a staged rehabilitation plan with progressive range-of-motion and strengthening. Typical site of service is an inpatient or outpatient hospital operating room or ambulatory surgery center depending on complexity and patient comorbidities. Common postoperative considerations include pain control, wound care, thromboprophylaxis as indicated, and outpatient physical therapy for restoration of function.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when the tendon transfer requires substantially greater work or complexity than typical (extensive dissection, multiple additional procedures beyond the basic transfer). |
23 | Unusual anesthesia | Use when general anesthesia is required but contraindicated normally for the procedure and additional anesthesia risk is documented. |
26 | Professional component | Use if reporting only the surgeon's professional component separate from technical facility charges (rare for surgical CPTs). |
50 | Bilateral procedure | Use when identical tendon transfer is performed on both thighs during the operative session. |
51 | Multiple procedures | Use when additional distinct procedures are performed during the same operative session. |
52 | Reduced services | Use when the procedure is intentionally not completed or is reduced in scope (partial tendon transfer). |
53 | Discontinued procedure | Use when the procedure is started but terminated due to extenuating circumstances. |
62 | Two surgeons | Use when two surgeons of different specialties work together as co-surgeons performing distinct portions of the transfer. |
63 | Procedure performed on infants less than 4 kg | Use when the patient meets the age/weight criterion and the modifier is required by payer policy. |
66 | Surgical team approach | Use when a documented surgical team provides distinct, necessary contributions beyond a single surgeon. |
80 | Assistant surgeon | Use when an assistant surgeon performs portions of the procedure under the operating surgeon's direction. |
81 | Minimum assistant surgeon | Use when only minimal assistant involvement is needed and allowed by payer policy. |
82 | Assistant not available | Use when a qualified assistant is unavailable and a substitute performed the assistant role. |
TC | Technical component | Use if reporting only facility/technical component separate from the surgeon's professional services (rare for operative codes). |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
| 207L00000X | Orthopedic Surgery | Orthopedic surgeons commonly perform thigh tendon transfers to restore limb function. |
| 2080P0231X | Physical Medicine & Rehabilitation | Physiatrists manage preoperative and postoperative rehabilitation and functional assessment. |
| 2086S0121X | Neurological Surgery | Neurosurgeons may be involved when tendon transfer addresses neurologic deficit or is part of combined nerve surgery. |
| 207K00000X | Sports Medicine (Orthopedic) | Sports medicine specialists perform tendon reconstruction/transfer for traumatic or functional deficits. |
| 2084P0902X | Hand Surgery (Orthopedic) | In rare complex reconstructive cases involving proximal-to-distal transfers, reconstructive specialists may be consulted. |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
M62.81 | Muscle weakness (generalized) | Indicates loss of muscle function that may prompt consideration of tendon transfer to restore active motion. |
S76.011A | Strain of muscle, fascia and tendon of right thigh, initial encounter | Traumatic injuries to thigh musculature or tendons that may result in deficiency requiring transfer for restoration. |
S76.012A | Strain of muscle, fascia and tendon of left thigh, initial encounter | As above for the contralateral thigh; relevant for laterality coding and bilaterality considerations. |
G83.1 | Monoplegia of lower limb | Neurologic paralysis of a single lower limb where tendon transfer can improve function. |
G83.4 | Cauda equina syndrome | Neurologic deficits from cauda equina may lead to distal muscle dysfunction addressed by tendon transfer when appropriate. |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
20820 | Surgical preparation and transfer of muscle(s) and tendon(s), thigh; major (e.g., transfer of gluteus maximus) | Codes for more extensive or major muscle-tendon transfers that may be performed for larger reconstructive needs; used when scope exceeds a single-tendon transfer. |
23420 | Tenotomy, open, for serous lesions; shoulder (not otherwise specified) — example of tendon procedures in other anatomic areas | Illustrates conceptually related tendon procedures in different anatomic sites; not performed concomitantly but useful for cross-reference in documentation of tendon surgery principles. |
29881 | Knee arthroscopy, surgical; synovectomy, major debridement | May be performed before or during reconstruction when intra-articular pathology requires treatment in the same operative session. |
27370 | Tenotomy, thigh; open (separate procedure) | Related soft-tissue procedures in the thigh that may be performed in combination with tendon transfer for balance or release. |
20670 | Ultrasound-guided injection, therapeutic; musculoskeletal, tendon sheath, ligament, or bursa | Performed perioperatively or diagnostically for tendon pathology or to guide conservative management prior to deciding on transfer. |