Summary & Overview
CPT 27658: Primary Flexor Tendon Repair of the Leg
CPT code 27658 represents a primary surgical repair of one or more flexor tendons in the leg without graft placement. This procedure is clinically significant for restoring mobility and reducing pain following tendon injuries, and it has implications for surgical resource use, postoperative rehabilitation, and payer coverage policies nationwide. The code captures a distinct surgical intervention that often requires operating room time, specialized surgical expertise, and coordinated post-operative care.
Key payers evaluated include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context, typical sites of service, and the types of benchmarks and policy aspects usually relevant to this code, including utilization measures, reimbursement considerations, and prior authorization trends. The publication will also summarize common billing modifiers and administrative considerations where applicable and note when input data is not available.
This summary is intended for national audiences including clinicians, coding professionals, and payer policy teams seeking a clear, practical understanding of the code’s clinical purpose and administrative relevance. Data not available in the input.
Billing Code Overview
CPT code 27658 describes a primary repair of one or more flexor tendons of the leg without graft placement. The procedure is performed to restore function and relieve pain in affected tendons.
-
Service type: Surgical tendon repair
-
Typical site of service: Hospital inpatient or outpatient surgical setting or ambulatory surgical center
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A 34-year-old male construction worker presents to the emergency department after a deep laceration to the posterior aspect of the lower leg from a metal edge while on site. Physical exam demonstrates loss of active plantarflexion and a palpable defect along the course of the flexor digitorum longus/flexor hallucis longus tendons with intact distal pulses and no open fracture on radiographs. After neurovascular assessment and tetanus update, the patient is taken to the operating room emergently for operative exploration and primary repair of one or more flexor tendons of the leg (CPT 27658) under general or regional anesthesia.
The clinical workflow includes preoperative planning (consent, imaging as needed), intraoperative tendon irrigation and debridement, identification and primary repair of the injured flexor tendon(s) without graft placement, layered wound closure, and application of a protective splint or cast. Postoperative care includes analgesia, wound checks, immobilization protocol, early supervised range-of-motion per surgeon/therapist protocol, and scheduled follow-up with clinic and hand/foot therapy to monitor tendon healing and restore function.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
50 | Bilateral Procedure | When identical tendon repairs are performed on both lower extremities during the same operative session |