Summary & Overview
CPT 27650: Primary Open or Percutaneous Repair of Achilles Tendon Tear
CPT code 27650 represents the primary open or percutaneous repair of an Achilles tendon tear, a common orthopedic procedure for acute ruptures treated soon after injury. Nationally, this code captures surgical interventions that restore tendon continuity and function and underpins payment and quality measurement for lower-extremity trauma care. The code is relevant across major payers and settings where acute tendon repairs are performed.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of clinical context for primary Achilles tendon repair, typical sites of service, and common billing considerations associated with acute operative management. The publication summarizes benchmark measures and payer coverage patterns when available, highlights policy and coding updates that affect billing and documentation, and explains where CPT code 27650 fits within surgical service lines for orthopedics.
Clinical context includes indications for primary repair versus delayed or reconstructive approaches and the procedural setting implications for facility and professional claims. Policy context addresses recurring coding clarifications and payer coverage themes relevant to acute tendon repair claims. Data not available in the input will be identified as such in applicable sections.
Billing Code Overview
CPT code 27650 describes a primary open or percutaneous repair of an Achilles tendon tear. This procedure involves direct surgical repair of the torn Achilles tendon, typically performed within a few days of injury when primary repair is appropriate.
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Service type: Surgical repair of tendon (orthopedic procedure)
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Typical site of service: Operative suite or ambulatory surgery center; may also occur in hospital inpatient settings depending on clinical need and timing.
Clinical & Coding Specifications
Clinical Context
A 42-year-old recreational runner presents to the emergency department after feeling a sudden pop in the back of the right ankle while sprinting. Examination reveals a palpable gap above the calcaneus, inability to plantarflex against resistance, and a positive Thompson test. Ultrasound confirms a complete midsubstance Achilles tendon rupture. The orthopedic surgeon schedules a primary open repair within 5 days of injury. The clinical workflow includes preoperative evaluation (history, focused lower-extremity exam, imaging confirmation), informed consent, perioperative anesthesia evaluation, operative primary open or percutaneous Achilles tendon repair (CPT 27650), intraoperative wound care and possible augmentation if needed, postoperative immobilization in a posterior splint or cast, and early referral to physical therapy for staged rehabilitation. Typical perioperative documentation includes laterality, timing relative to injury (primary repair within days), operative technique (open vs percutaneous), estimated blood loss, implants used if any, and detailed postoperative instructions. The typical site of service is an ambulatory surgery center or hospital operating room for cases requiring regional or general anesthesia; minor percutaneous repairs may occur in outpatient procedural suites.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
50 | Bilateral Procedure | Use when both Achilles tendons are repaired during the same operative session. |