Summary & Overview
CPT 27400: Hamstring Muscle/Tendon Transfer to Femur
CPT code 27400 represents surgical transfer of a hamstring muscle or tendon to the femur, a reconstructive orthopedic procedure frequently used to treat spasticity and gait abnormalities in patients with cerebral palsy. Nationally, this code matters because it captures a targeted, function-restoring intervention that affects surgical case-mix, post-operative rehabilitation needs, and specialty reimbursement patterns.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context and common sites of service, plus benchmarks and payer policy considerations where available. The publication outlines typical utilization drivers, coding guidance, and areas where policy updates or documentation clarification commonly appear. It also highlights implications for surgical departments and post-acute care planning.
This summary is intended for a national audience of policy analysts, billing professionals, and surgical providers seeking to understand the role of CPT code 27400 in clinical practice and payer coverage frameworks. Data not available in the input will be noted where applicable.
Billing Code Overview
CPT code 27400 describes a surgical procedure in which a hamstring muscle or tendon is transferred to the femur, commonly performed to address muscle imbalance and spasticity in patients with cerebral palsy. The procedure typically involves detaching a portion of the hamstring and reattaching it to the femur to improve gait mechanics and reduce flexion deformity of the knee.
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Service type: Orthopedic reconstructive surgery, soft-tissue transfer
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Typical site of service: Inpatient or outpatient surgical setting, most commonly performed in an operating room within a hospital or ambulatory surgery center
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Clinical & Coding Specifications
Clinical Context
A typical patient is a pediatric or young adult with spastic cerebral palsy and persistent knee flexion deformity or hamstring overactivity causing crouched gait. The child presents to a multidisciplinary team including pediatric orthopedics and physical therapy after conservative measures (physical therapy, serial casting, botulinum toxin) provide insufficient improvement. Preoperative evaluation includes gait analysis, focused physical exam demonstrating fixed or dynamic knee flexion contracture and hamstring tightness, imaging as indicated, and anesthetic assessment. The surgical workflow: preoperative planning and informed consent; general anesthesia with regional block as appropriate; surgical transfer of the hamstring tendon (often semitendinosus or gracilis) and reattachment to the femur to reduce knee flexion moment; intraoperative neurovascular monitoring as indicated; wound closure and dressing; postoperative admission or observation for pain control and neurologic checks; initiation of a structured rehabilitation program with weight-bearing instructions, bracing if required, and outpatient physical therapy focused on gait retraining. Typical site of service is an inpatient hospital operating room or ambulatory surgical center depending on patient age, comorbidities, and complexity of the procedure. Payors commonly involved include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, BUCA, and Medicare.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services |