2025 CPT code 27146
(Active) Effective Date: N/A Revision Date: N/A Surgery - Pelvis and Hip Joint Musculoskeletal System Feed
Osteotomy of the iliac, acetabular, or innominate bone.
Modifiers can be used with 27146 to indicate specific circumstances of the procedure, such as increased procedural services (22), bilateral procedures (50), or reduced services (52).
Medical necessity for this procedure is established by documenting the underlying hip condition, such as hip dysplasia, slipped capital femoral epiphysis, or other deformities, and demonstrating how the osteotomy will improve hip joint stability, function, or pain.
The physician performing the osteotomy is responsible for the procedure, including preoperative planning, surgical execution, and postoperative care. This may involve obtaining bone grafts, stabilizing the hip joint, and managing any complications.
- Musculoskeletal System
- Repair, Revision, and/or Reconstruction Procedures on the Pelvis and Hip Joint
In simple words: This procedure reshapes the hip bone to improve hip joint stability and prevent arthritis. The surgeon cuts and repositions part of the pelvic bone to create a better fit for the hip joint. This is often done in children with hip problems.
This procedure involves cutting a portion of the iliac, acetabular, or innominate bone of the pelvis. The ilium is the upper portion of the pelvic girdle. The acetabulum is the cup-shaped socket of the hip joint. The innominate bone consists of the fused ilium, ischium, and pubis.
Example 1: A 4-year-old child with residual hip dysplasia undergoes a Pemberton osteotomy to correct the acetabular dysplasia., A 10-year-old child with a slipped capital femoral epiphysis undergoes an innominate osteotomy to improve hip joint stability., A 15-year-old adolescent with hip pain and acetabular dysplasia undergoes a periacetabular osteotomy (PAO) to realign the hip joint.
Documentation should include the operative report detailing the specific type of osteotomy performed, the size and location of the bone incision, any bone grafts used, and the method of fixation. Preoperative imaging and diagnostic reports supporting the medical necessity of the procedure should also be included.
- Revenue Code: P3D - MAJOR PROCEDURE, ORTHOPEDIC - OTHER
- Payment Status: Active
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center