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2025 CPT code 27236

Open treatment of a femoral neck fracture, proximal end, involving internal fixation or prosthetic replacement.

Follow the official CPT coding guidelines for musculoskeletal procedures and fracture care.Consider modifiers as needed (e.g., 50 for bilateral procedures, 51 for multiple procedures).

Modifiers 50 (bilateral procedure), 51 (multiple procedures), 76 (repeat procedure), and others may be applicable depending on the circumstances.

Medical necessity is established by the presence of a symptomatic femoral neck fracture requiring surgical intervention for fracture reduction and fixation or prosthetic replacement to restore functional mobility and prevent complications such as avascular necrosis.

The orthopedic surgeon is responsible for performing the surgical procedure, including pre-operative planning, intraoperative fracture reduction and fixation (or prosthetic replacement), and post-operative care instructions.

IMPORTANT Code 27125 (hemiarthroplasty, hip, partial) is used for hemiarthroplasty due to degenerative conditions, not fractures.Other codes, such as those for intertrochanteric fractures (27244, 27245) might be applicable depending on the specific fracture location and treatment.

In simple words: This code covers open surgery to repair a broken bone in the upper part of the thigh bone (femur neck).The doctor makes an incision to fix the broken bone using screws, plates, or other implants. If the bone is severely damaged, the doctor may replace part of the bone with an artificial implant.

This CPT code reports the open surgical treatment of a fracture in the neck of the femur (proximal end). The procedure involves direct surgical exposure of the fracture site. Treatment includes reduction of the fracture fragments and internal fixation using implants such as screws, pins, plates, or nails.If the bone damage is extensive, a prosthetic replacement may be necessary.The code encompasses the surgical steps involved in exposing the fracture, reducing the fragments, and stabilizing them with internal fixation or prosthetic replacement.Additional procedures like vessel exploration or neuroplasty are reported separately.

Example 1: A 70-year-old female falls and sustains a displaced femoral neck fracture.Open reduction and internal fixation (ORIF) with a cannulated hip screw is performed., An 85-year-old male with osteoporosis suffers a comminuted femoral neck fracture.A hemiarthroplasty (partial hip replacement) is performed due to the severity of the fracture., A 60-year-old male sustains a femoral neck fracture in a motor vehicle accident.The fracture is reduced and fixed using a dynamic hip screw.Post-operative rehabilitation is indicated.

* Pre-operative diagnostic imaging (X-rays, CT scans) demonstrating the fracture.* Operative report detailing the surgical approach, fracture reduction technique, implants used, and estimated blood loss.* Post-operative imaging confirming fracture reduction and implant placement.* Pathology report (if applicable, e.g., bone biopsy).* Anesthesia record.

** This code is used for open treatment of femoral neck fractures.Closed treatment, percutaneous fixation, and other treatment modalities have their own distinct codes.The selection of the appropriate code depends on the specific surgical technique and the extent of the fracture.

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