CPT® Code 27676

The procedure described by CPT® Code 27676 involves the surgical repair of dislocating peroneal tendons, specifically with the addition of a fibular osteotomy. The peroneal tendons, which include the peroneus longus and peroneus brevis, are critical structures located in the lateral compartment of the lower leg. These tendons traverse the ankle joint and are housed within a common tendon sheath, which is bordered by various anatomical structures including the fibular sulcus and ligaments. Dislocation of these tendons typically occurs due to injury to the superior retinaculum, which is responsible for maintaining their proper position. In this procedure, a more invasive approach is taken compared to CPT® Code 27675, which addresses dislocation without the need for a fibular osteotomy. The surgical intervention begins with an incision over the lateral aspect of the ankle, allowing for direct inspection of the retinaculum and the peroneal tendons. If the retinaculum is found to be insufficient to cover the tendons, additional surgical techniques may be employed, such as deepening the peroneal groove or reinforcing the retinaculum with surrounding structures like the Achilles tendon. The key distinction in CPT® Code 27676 is the performance of a fibular osteotomy, specifically a sliding distal fibular osteotomy. This involves making precise bone cuts in the distal fibula to facilitate the rotation of a bone fragment, which acts as a mechanical block to prevent the anterior displacement of the peroneal tendons. The secured bone fragment, typically fastened with screws, provides enhanced stability and reduces the likelihood of future dislocations, thereby addressing the underlying issue more effectively than simpler repair techniques.