CPT 27685 Tendon Repair Reimbursement & Policy | OpenPayer

Summary & Overview

CPT 27685: Tendon Repair for Leg or Foot Deformity

CPT code 27685 represents surgical repair of a single tendon in the leg or foot to correct contracture or congenital or acquired deformity, including lengthening or shortening of the tendon to restore function and relieve pain. This procedure is clinically significant for orthopedics and podiatry, contributing to functional restoration and pain reduction for patients with tendon dysfunction.

Key national payers included in this review are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of clinical indications and typical care settings, plus coverage and billing considerations relevant to major payers. The publication outlines common modifiers used with this service and notes where data is not provided in the input.

The article provides practical benchmarks and policy context useful for coding, claims submission, and payer communications, along with a concise description of where the service is typically performed (hospital operating room or ambulatory surgery center). Data not available in the input is identified where applicable, including detailed payer-specific reimbursement rates, associated taxonomies, ICD-10 diagnoses, and related procedure codes.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare27685CPTtendon repairorthopedicspodiatrysurgical procedureambulatory surgeryoperating roomprocedure coding

Billing Code Overview

CPT code 27685 describes surgical repair of a contracture or other congenital or acquired deformity in a single tendon of the leg or foot. The procedure may involve lengthening a short tendon or shortening an excessively long tendon to restore function and relieve pain.

Service type: Surgical tendon repair/reconstruction of the leg or foot
Typical site of service: Hospital operating room or ambulatory surgery center

Clinical & Coding Specifications

Clinical Context

A 45-year-old patient presents with progressive equinus deformity of the ankle and foot causing altered gait, pain with ambulation, and difficulty fitting footwear. Conservative measures including stretching, physical therapy, orthotics, and corticosteroid injections have failed. Examination reveals a tight Achilles tendon with limited dorsiflexion and compensatory forefoot overload. The orthopedic foot and ankle surgeon schedules operative correction using a tendon lengthening/shortening procedure to restore ankle dorsiflexion and improve function.

The clinical workflow includes preoperative evaluation with medical clearance, informed consent outlining risks and benefits, preoperative imaging as indicated (weight-bearing radiographs), perioperative anesthesia assessment (regional block or general anesthesia), intraoperative identification of the implicated single tendon (commonly the Achilles or posterior tibial tendon), performance of the tendon lengthening or shortening procedure to correct contracture, wound closure, and immediate postoperative immobilization in a cast or boot. Postoperative care includes pain control, wound checks, progressive weight bearing as directed, and outpatient physical therapy for range of motion and strengthening to restore gait and function.

Coding Specifications

Modifier	Description	When to Use
`LT`	Left side	Use when the procedure is performed on the left leg/foot.

CPT 27702: Total Ankle Reconstruction with Implant

CPT-27732-DISTAL-FIBULA-GROWTH-PLATE-FUSION-LEG-LENGTH-EQUALIZATION

CPT 27732: Distal Fibula Growth Plate Fusion to Equalize Leg Length

CPT-27686-MULTIPLE-TENDON-REPAIR-LEG-ANKLE

CPT 27686: Multiple Tendon Repair, Leg or Ankle

CPT-27658-FLEXOR-TENDON-REPAIR-LEG-PRIMARY

CPT 27658: Primary Flexor Tendon Repair of the Leg

CPT-27650-ACHILLES-TENDON-PRIMARY-REPAIR

CPT 27650: Primary Open or Percutaneous Repair of Achilles Tendon Tear

CPT-27726-FIBULAR-NONUNION-MALUNION-REPAIR-INTERNAL-FIXATION

CPT 27726: Repair of Fibular Nonunion or Malunion with Internal Fixation

CPT-27659-FLEXOR-TENDON-REPAIR-LEG-REVISION

CPT 27659: Revision Repair of Flexor Tendons of the Leg

CPT-27725-TIBIAL-NONUNION-OR-MALUNION-TIBIOFIBULAR-FUSION

CPT 27725: Tibial Nonunion or Malunion Repair with Tibiofibular Fusion

CPT-27691-FOOT-TENDON-TRANSFER-SINGLE-DEEP-TENDON-TRANSFER

CPT 27691: Single Deep Tendon Transfer or Transplant of Foot

CPT-27734-TIBIAL-FIBULAR-GROWTH-MODULATION-EPIPHYSIODESIS

CPT 27734: Distal Tibia and Fibula Growth Plate Fusion (Epiphysiodesis)

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Taxonomy Code	Specialty	Notes
`207L00000X`	Orthopaedic Surgery	Foot and ankle or general orthopedic surgeons commonly perform tendon lengthening/shortening.
`207P00000X`	Podiatry (Podiatric Medicine & Surgery)	DPMs with surgical privileges frequently perform tendon procedures of the foot and ankle.
`207K00000X`	Orthopaedic Surgery of the Foot & Ankle	Specialized taxonomy for surgeons focusing on foot and ankle pathology.
`208000000X`	Physical Medicine & Rehabilitation	PM&R physicians may be involved in pre/postoperative nonoperative care and rehabilitation planning.
`207R00000X`	General Surgery	Rarely involved; included for settings where general surgeons provide lower-extremity tendon surgery (uncommon).

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`M21.371`	Flat foot [pes planus], right foot	Pes planus can be associated with tendon contracture or dysfunction requiring tendon lengthening or transfer.
`M21.372`	Flat foot [pes planus], left foot	Same relevance for left-sided presentation.
`M24.271`	Ankylosis, ankle and foot	Joint ankylosis can create secondary tendon contracture addressed by tendon procedures.
`M67.471`	Other spontaneous disruption of tendon, right lower leg	Tendon pathology leading to altered function may necessitate repair or length modification.
`M67.472`	Other spontaneous disruption of tendon, left lower leg	Contralateral counterpart with similar relevance.
`M62.871`	Muscle weakness (generalized) of right lower limb	Muscle imbalance or weakness can contribute to deformity and need for tendon correction.
`Q66.4`	Congenital talipes equinovarus (clubfoot)	Congenital deformities often require tendon lengthening to correct contracture and improve function.
`M21.37`	Other acquired foot deformities	General code for acquired deformities that may require tendon lengthening or shortening

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`27650`	Percutaneous tenotomy, Achilles tendon	May be used as a less invasive alternative to open tendon lengthening for select patients.
`27654`	Repair, tendo calcaneus, primary or secondary; direct (e.g., end-to-end)	Used when primary repair of the Achilles tendon is required rather than lengthening/shortening for contracture.
`27652`	Repair, tendo calcaneus, primary or secondary; augmentation (e.g., graft)	Employed when tendon reconstruction with graft or augmentation is performed alongside lengthening/shortening.
`27690`	Tenolysis, flexor or extensor tendon, leg or foot; single tendon	Performed when adhesions limit tendon glide and tenolysis is needed in the same operative setting.
`28820`	Tenotomy, percutaneous, metatarsophalangeal (e.g., hammer toe)	Related forefoot soft-tissue procedures that may be performed during the same ankle/foot reconstructive case.
`29515`	Application of short leg cast (below knee)	Often performed postoperatively for immobilization after tendon lengthening/shortening.

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