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Official Description

Tenolysis, flexor or extensor tendon, leg and/or ankle; single, each tendon

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

Tenolysis is a surgical procedure aimed at freeing a tendon from the surrounding tissue that may be restricting its movement. Specifically, CPT® Code 27680 refers to the tenolysis of a single flexor or extensor tendon located in the leg and/or ankle. This procedure is typically indicated when scar tissue has formed around the tendon due to trauma or a disease process, which can impede the normal motion of the ankle, foot, and/or toes. The goal of tenolysis is to restore the range of motion by carefully releasing these adhesions. During the procedure, a surgical incision is made directly over the affected tendon, allowing the surgeon to access the area. The surrounding soft tissues are meticulously dissected to expose the tendon, which is then identified. Once the tendon is visualized, any adhesions that are restricting its movement are severed. After the release of the tendon, the surgeon evaluates the range of motion to ensure that the procedure has been successful. Finally, the surgical wound is closed in layers, and a dressing is applied to protect the area as it heals. This procedure is distinct from CPT® Code 27681, which involves tenolysis of multiple tendons and is typically performed through separate incisions.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

Tenolysis, as described by CPT® Code 27680, is indicated for patients experiencing restricted motion in the ankle, foot, and/or toes due to the presence of scar tissue surrounding a flexor or extensor tendon. The following conditions may warrant the performance of this procedure:

  • Scar Tissue Formation Scar tissue may develop as a result of trauma, surgical intervention, or inflammatory processes affecting the tendon.
  • Adhesive Capsulitis This condition can lead to stiffness and pain in the ankle and foot, necessitating the release of the tendon to restore mobility.
  • Tendon Injury Injuries to the tendon that result in the formation of adhesions can impede normal function and require surgical intervention.

2. Procedure

The procedure for tenolysis of a single flexor or extensor tendon, as outlined in CPT® Code 27680, involves several critical steps to ensure successful release and restoration of tendon function.

  • Step 1: Incision The procedure begins with the surgeon making an incision over the affected tendon in the lower leg or ankle. This incision is strategically placed to provide optimal access to the tendon while minimizing damage to surrounding tissues.
  • Step 2: Dissection of Soft Tissues Following the incision, the surgeon carefully dissects the surrounding soft tissues to expose the tendon. This step requires precision to avoid injury to nearby structures and to ensure a clear view of the tendon.
  • Step 3: Identification of the Affected Tendon Once the tendon is exposed, the surgeon identifies the specific flexor or extensor tendon that is affected by adhesions. Accurate identification is crucial for the success of the procedure.
  • Step 4: Severing of Adhesions The next step involves the careful severing of any adhesions that are restricting the movement of the tendon. This is done with meticulous attention to detail to ensure that the tendon is freed without causing additional damage.
  • Step 5: Evaluation of Range of Motion After the adhesions have been released, the surgeon evaluates the range of motion of the tendon to assess the effectiveness of the procedure. This evaluation helps determine if further intervention is necessary.
  • Step 6: Closure of the Surgical Wound Once the evaluation is complete, the surgical wound is closed in layers. This layered closure technique helps to promote optimal healing and reduces the risk of complications.
  • Step 7: Application of Dressing Finally, a dressing is applied to the surgical site to protect it during the initial healing phase. Proper dressing is essential for preventing infection and supporting recovery.

3. Post-Procedure

After the tenolysis procedure, patients can expect a recovery period that may involve specific post-operative care instructions. It is important to monitor the surgical site for any signs of infection or complications. Patients may be advised to keep the affected area elevated and to limit movement to promote healing. Physical therapy may be recommended to help restore strength and flexibility in the tendon and surrounding muscles. The duration of recovery can vary based on individual circumstances, but follow-up appointments will be necessary to assess healing and functional recovery.

Short Descr RELEASE OF LOWER LEG TENDON
Medium Descr TENOLYSIS FLXR/XTNSR TENDON LEG&/ANKLE 1 EACH
Long Descr Tenolysis, flexor or extensor tendon, leg and/or ankle; single, each tendon
Status Code Active Code
Global Days 090 - Major Surgery
PC/TC Indicator (26, TC) 0 - Physician Service Code
Multiple Procedures (51) 2 - Standard payment adjustment rules for multiple procedures apply.
Bilateral Surgery (50) 0 - 150% payment adjustment for bilateral procedures does NOT apply.
Physician Supervisions 09 - Concept does not apply.
Assistant Surgeon (80, 82) 1 - Statutory payment restriction for assistants at surgery applies to this procedure...
Co-Surgeons (62) 1 - Co-surgeons could be paid, though supporting documentation is required...
Team Surgery (66) 0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator Hospital Part B services paid through a comprehensive APC
ASC Payment Indicator Surgical procedure on ASC list in CY 2007; payment based on OPPS relative payment weight.
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) P5B - Ambulatory procedures - musculoskeletal
MUE 2
CCS Clinical Classification 160 - Other therapeutic procedures on muscles and tendons
LT Left side (used to identify procedures performed on the left side of the body)
59 Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25.
XU Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service
RT Right side (used to identify procedures performed on the right side of the body)
22 Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service.
51 Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d).
58 Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78.
76 Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service.
78 Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.)
79 Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.)
80 Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s).
82 Assistant surgeon (when qualified resident surgeon not available): the unavailability of a qualified resident surgeon is a prerequisite for use of modifier 82 appended to the usual procedure code number(s).
AS Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery
CC Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed)
CR Catastrophe/disaster related
ET Emergency services
GC This service has been performed in part by a resident under the direction of a teaching physician
GW Service not related to the hospice patient's terminal condition
SG Ambulatory surgical center (asc) facility service
T1 Left foot, second digit
T2 Left foot, third digit
T5 Right foot, great toe
T6 Right foot, second digit
T7 Right foot, third digit
TV Special payment rates, holidays/weekends
XS Separate structure, a service that is distinct because it was performed on a separate organ/structure
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