CPT® Code 27690

Transfer or transplant of single tendon (with muscle redirection or rerouting); superficial (eg, anterior tibial extensors into midfoot)

Tendon transplantation or transfer of a single tendon of the lower leg is a surgical procedure aimed at restoring function that may have been compromised due to various conditions, most commonly resulting from traumatic injuries to the nerve, tendon, or muscle. In some cases, the loss of function can also be attributed to chronic conditions such as rheumatoid arthritis or gouty arthritis. The specific approach taken during the procedure can vary significantly based on the particular function that the surgeon aims to restore. In the context of CPT® Code 27690, the procedure involves a superficial transfer or transplant of a single tendon, with the anterior tibial extensors being the most frequently transferred tendons into the midfoot region. The surgical technique typically begins with a longitudinal incision made over the donor tendon, allowing for exposure and subsequent mobilization of the tendon. This involves freeing the donor tendon from its attachments, which may include harvesting it along with a strip of periosteum to ensure adequate length and mobility for the transfer. Following this, a second incision is made at the recipient site where the tendon will be anchored. The donor tendon is then routed to this site, temporarily secured, and tested for function using a neuromuscular stimulator. Adjustments to the tension of the donor tendon are made as necessary to optimize its function before it is permanently secured. After the surgical wounds are closed, immobilization of the ankle and foot is often required to facilitate proper healing.