Summary & Overview
CPT 27690: Single Tendon Transfer or Transplant
Headline: CPT code 27690: Single Tendon Transfer or Transplant Restores Lower-Extremity Function. Lead: CPT code 27690 captures a focused surgical intervention in which a single tendon is transferred or transplanted (for example, anterior tibial tendon to midfoot) to restore function lost from disease, paralysis, or injury. This code is significant for national surgical billing and coverage because it represents a specialized reconstructive orthopedics/foot and ankle procedure with implications for payer authorization, facility use, and surgical resource planning.
Why it matters nationally: Tendon transfer procedures affect mobility and long-term functional outcomes; accurate coding supports appropriate reimbursement and tracking of reconstructive surgical care. Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
What readers will learn: This publication explains the clinical scope of CPT code 27690, typical settings where the service is delivered, and common coding considerations. Readers will find benchmarks and payer coverage context where available, concise clinical context about indications for tendon transfer or transplant, and notes on common modifiers associated with surgical procedures. Data not available in the input includes specific payer fee schedules, ICD-10 diagnosis pairings, and taxonomy details.
Billing Code Overview
CPT code 27690 describes a single tendon transfer or transplant procedure. The provider performs a transfer or transplant of one tendon (for example, transferring the anterior tibial tendon extensors into the midfoot) to restore function lost due to diseased, paralyzed, or injured tendon.
Service Type
- Surgical procedure involving tendon transfer or transplant to restore limb or foot function
Typical Site of Service
- Hospital operating room or ambulatory surgical center, depending on case complexity and patient status
Clinical & Coding Specifications
Clinical Context
A typical patient is a 32-year-old male who presents with foot drop and progressive ankle instability after a peripheral nerve injury sustained in a motorcycle crash six months earlier. Conservative management including physical therapy, ankle-foot orthosis, and electromyography-guided rehabilitation produced insufficient dorsiflexion recovery. Imaging and clinical exam demonstrate a dysfunctional anterior tibialis tendon with preserved donor tendon function in the midfoot. The orthopedic foot and ankle surgeon schedules a single tendon transfer (e.g., anterior tibial tendon transfer to the midfoot) to restore active dorsiflexion and improve gait.
Preoperative workflow includes history and physical, focused neurologic and vascular exam, plain radiographs ± MRI of the foot/ankle, informed consent, and preoperative anesthesia evaluation. Intraoperative steps include exposure of donor and recipient tendons, mobilization and rerouting of the anterior tibial tendon, tensioning and fixation to the midfoot structures, and layered wound closure. Postoperative care includes immobilization in a cast or boot, non‑weight bearing or protected weight bearing as indicated, pain control, wound checks, and staged rehabilitation with progressive range of motion and strengthening over 8–12 weeks.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
59 | Distinct procedural service | When another procedure on the same day is separate and not usually performed together with the tendon transfer (e.g., separate incision site or unrelated procedure). |