Summary & Overview
CPT 27665: Repair of Extensor Tendons of the Leg, Revision
CPT code 27665 covers surgical repair of one or more extensor tendons of the leg in patients who have had a prior repair, with or without graft placement. This revision tendon repair procedure is clinically significant because it addresses persistent dysfunction, recurrent rupture, or pain after an initial repair — issues that can affect mobility, rehabilitation needs, and downstream costs of care. Nationally, procedures for complex tendon reconstruction are performed across hospital operating rooms and ambulatory surgery centers and are relevant to both commercial payers and public programs.
Key payers in typical coverage analyses include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical context for the procedure, expected sites of service, common billing modifiers (where provided), and how this code is commonly grouped with related surgical services. The publication also outlines benchmarking elements and policy considerations that influence prior authorization, claim edits, and bundling decisions. Data not available in the input is noted where applicable. The content is intended to inform coding accuracy, payer interactions, and operational planning for surgical teams and billing staff nationwide.
Billing Code Overview
CPT code 27665 describes the repair of one or more extensor tendons of the leg, performed in a patient who previously had a tendon repair. The procedure may include placement of a graft and is intended to restore function and relieve pain after a failed or recurrent extensor tendon repair.
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Service type: Surgical tendon repair (revisional/secondary procedure)
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Typical site of service: Operating room or ambulatory surgery center, with inpatient setting possible for complex cases or patients requiring extended postoperative care.
Clinical & Coding Specifications
Clinical Context
A 34-year-old male presents with persistent dorsum-of-foot pain, weakness of toe extension, and recurrent functional limitation after an initial extensor tendon repair of the leg performed 9 months earlier following a laceration. Physical exam demonstrates a palpable defect and decreased active extension at the ankle/foot. Imaging (ultrasound and MRI) shows partial failure of the prior repair with adhesions and tendon retraction. The patient is scheduled for revision repair of one or more extensor tendons of the leg, with possible graft placement if native tendon length/quality is insufficient.
The clinical workflow includes preoperative evaluation and informed consent, pre-op imaging review, intraoperative exposure of the extensor compartment, debridement of scar tissue and old suture material, assessment of tendon ends, primary revision repair or interposition graft if required, layered wound closure, and post-op splinting/casting. Postoperative care includes pain control, immobilization, staged physical therapy focusing on range of motion and progressive strengthening, and serial follow-up visits to assess wound healing and functional recovery. Documentation includes operative report specifying CPT 27665, prior repair status, graft usage, laterality, anesthesia type, estimated blood loss, and postoperative instructions.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
LT | Left side |