Summary & Overview
CPT 27691: Single Deep Tendon Transfer or Transplant of Foot
CPT code 27691 denotes a single deep tendon transfer or transplant in the foot performed to restore function lost from disease, paralysis, or injury. This operative code captures a distinct reconstructive foot tendon procedure used in orthopedic and reconstructive practice. Nationally, accurate coding for 27691 affects surgical quality measurement, facility and professional billing, and case mix classification for foot and ankle care.
Key payers in this national overview include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical context for the procedure, typical sites of service, common modifiers used in billing, and the set of payers that commonly reimburse for this service. The publication also outlines what to expect in benchmarks and policy references where available and highlights areas where input data was not provided.
This summary is intended to inform billing managers, clinicians, and policy analysts about the clinical meaning of the code, its operational setting, and the payer landscape addressed in the companion sections. Data not available in the input will be identified in the detailed sections that follow.
Billing Code Overview
CPT code 27691 describes a single deep tendon transfer or transplant of a foot tendon performed to restore function lost due to a diseased, paralyzed, or injured tendon. The procedure involves mobilizing and reattaching or transferring one tendon in the foot to reestablish active movement or correct deformity.
Service type: Surgical procedure — tendon transfer/transplant of the foot
Typical site of service: Hospital operating room or ambulatory surgery center
Clinical & Coding Specifications
Clinical Context
A 46-year-old patient presents with progressive foot drop and impaired ankle dorsiflexion following a prior peroneal nerve injury sustained in a motorcycle collision 18 months earlier. Conservative management including bracing, physical therapy, and neuromuscular reeducation produced inadequate functional improvement. The orthopedic foot and ankle surgeon evaluates gait, strength, and tendon integrity and documents weakness of the tibialis anterior with intact posterior tibial tendon and available donor tendon (e.g., posterior tibialis or peroneus longus) suitable for transfer. Preoperative planning includes imaging (radiographs, possible MRI), neurovascular assessment, and medical clearance. In the operating room under regional or general anesthesia, the surgeon performs a single deep tendon transfer — detaching the donor tendon and rerouting it to the dorsiflexor insertion to restore active ankle dorsiflexion. Postoperative care includes immobilization in a splint or cast, nonweightbearing or protected weightbearing per surgeon protocol, analgesia, anticoagulation as indicated, and structured rehabilitation with progressive strengthening and range-of-motion therapy. Typical sites of service are an inpatient hospital operating room or ambulatory surgical center depending on comorbidities and expected recovery. The service type is surgical, reconstructive tendon transfer of the foot intended to restore lost function due to diseased, paralyzed, or injured tendon.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
59 | Distinct procedural service |