2025 CPT code 27599
(Active) Effective Date: N/A Revision Date: N/A Surgery - Other Procedures on the Femur or Knee Joint Musculoskeletal System Feed
Unlisted procedure on the femur or knee.
Modifiers may be applicable depending on the circumstances of the service.For example, modifier 50 (bilateral procedure) might be used if the procedure was performed on both knees or femurs.Other modifiers may be necessary depending on the specific situation.
The medical necessity must be clearly established in the documentation.This includes a comprehensive explanation of the patient's condition, why the procedure was necessary, and how it was the most appropriate treatment option given the clinical presentation and any comorbidities.
The surgeon performs the unlisted procedure on the femur or knee.
- Musculoskeletal System
- Surgical Procedures on the Musculoskeletal System > Surgical Procedures on the Femur (Thigh Region) and Knee Joint > Other Procedures on the Femur or Knee Joint
In simple words: This code is for a surgery on the thigh bone (femur) or knee that doesn't have a specific code.Doctors use it when the surgery doesn't exactly match any of the existing codes.They need to give a very detailed explanation of what they did to get paid for the surgery.
This CPT code reports surgical procedures performed on the femur or knee that do not have a specific code available within the CPT code set.It is used when the procedure performed does not precisely match any existing, currently active code.The use of this code requires thorough documentation to support the medical necessity and justify the billed amount.The description of the procedure should be detailed and specific.
Example 1: A surgeon performs a novel arthroscopic technique to repair a complex meniscal tear in the knee that is not currently represented in the CPT code set. , A surgeon performs a minimally invasive technique to treat a rare type of femoral fracture that requires a unique surgical approach not yet included in the CPT code set. , A surgeon performs a revision surgery on a total knee replacement requiring the removal of significant bone and soft tissue followed by the replacement of a custom-designed implant.
* Detailed operative report describing the procedure, including specific techniques used.* Preoperative and postoperative imaging studies (X-rays, CT scans, MRI).* Thorough explanation for using unlisted code 27599, with comparison to similar procedures and codes.* Justification of medical necessity.
** When using an unlisted code, ensure all necessary documentation is submitted to avoid claim denials. Thorough and detailed documentation is critical for appropriate reimbursement.
- Revenue Code: P3D (MAJOR PROCEDURE, ORTHOPEDIC - OTHER)
- RVU: The RVUs for this code will vary depending on the specific procedure performed and the geographic location.It is crucial to consult the appropriate fee schedule for determination.
- Global Days : The global period will vary based on the specific procedure performed and will need to be determined by consulting the appropriate guidelines.
- Payment Status: Active
- Modifier TC rule: The application of a technical component (TC) modifier is not generally applicable to this unlisted code as the procedure is usually performed by the same provider.However, it's vital to review the payer's guidelines for specific rules.
- Fee Schedule : The historical fee schedule data is unavailable for this unlisted code. Payment rates will need to be determined based on the documentation supporting the work performed and the payer's fee schedule.
- Specialties:Orthopedic Surgery
- Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center