Summary & Overview
CPT 27692: Additional Tendon Transplant or Transfer
CPT code 27692 covers the transplant or transfer of one or more additional tendons performed in the same operative session after an initial single tendon transplant. This code captures add-on surgical work aimed at restoring tendon function lost to disease, paralysis, or injury. Nationally, accurate use of this code matters for clinical documentation, operative reporting, and correct surgical reimbursement for complex reconstructive procedures.
Key payers addressed in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the code’s clinical intent and service context, typical sites of service, and common billing practices. The publication also provides benchmarking considerations, common modifier usages, and areas where documentation influences payment outcomes. Where payer-specific coverage language exists, high-level patterns in prior authorization and bundling with primary tendon procedures are discussed.
Intended audience includes surgical specialists, coding and billing professionals, and health policy analysts seeking a national-level understanding of how 27692 is used in reconstructive tendon surgery. Data not available in the input is clearly indicated where applicable.
Billing Code Overview
CPT code 27692 describes a surgical procedure in which, after an initial single tendon transplant, the provider performs a transplant or transfer of one or more additional tendons during the same operative session. The intent of the procedure is to restore function lost due to diseased, paralyzed, or injured tendon.
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Service type: Surgical tendon transplant or tendon transfer as an additional procedure performed in the same operative session following an initial single tendon transplant.
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Typical site of service: Inpatient or outpatient surgical setting, including hospital operating room or ambulatory surgical center, depending on clinical complexity and facility capabilities.
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Clinical & Coding Specifications
Clinical Context
A 42-year-old male presents after a work-related crush injury to the forearm with loss of flexor tendon function in multiple digits. Imaging and clinical exam confirm a ruptured flexor digitorum profundus tendon and attritional damage to adjacent flexor tendons. During the operative session, the surgeon performs an initial single-tendon transfer or transplant to restore primary function and then performs an additional tendon transfer for one or more adjacent tendons in the same anesthetic session. The procedure is performed in an operating room with regional block or general anesthesia. Intraoperative steps include exposure of the injured tendons, harvest or identification of donor tendon(s), securing grafts or transfers to tendon stumps with appropriate suture technique, tensioning, and verification of passive range of motion. Postoperative care includes immobilization in a splint, early controlled mobilization per hand therapy protocol, pain control, and follow-up visits for wound check and progressive rehabilitation. Typical sites of service are hospital outpatient surgery centers or ambulatory surgical centers.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
59 | Distinct procedural service | Use when an additional tendon procedure is performed at a distinct anatomical site or separate session component from another billed procedure when documentation supports distinctness. |