2025 CPT code 27415
(Active) Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures on the Musculoskeletal System Musculoskeletal System Feed
Open surgical placement of an osteochondral allograft in the knee.
Modifiers may be applicable depending on the circumstances of the procedure.For example, modifier 22 may be used for increased procedural services if multiple lesions are repaired.Modifiers 51 (multiple procedures), 59 (distinct procedural service), and 76 (repeat procedure) may be considered depending on the clinical scenario.
Medical necessity is established by the presence of a symptomatic osteochondral defect causing significant pain, limited range of motion, and functional impairment.Conservative treatment options (e.g., physical therapy, medication) have failed to provide adequate relief.
The orthopedic surgeon is responsible for all aspects of the procedure, including preoperative planning, surgical technique, postoperative care, and follow-up.This includes prepping the patient, applying a tourniquet, making the incision, debriding the lesion, preparing and placing the allograft, closing the wound, and confirming range of motion.
In simple words: The doctor makes an open incision in the knee to fix damaged cartilage and bone using a tissue graft from a donor. They clean the damaged area, prepare the graft, place it, and check the knee's movement afterward.
Open surgical procedure involving direct access to the knee joint to repair an osteochondral defect using an allograft.The procedure includes debridement, measurement, and marking of the lesion; preparation of the allograft for implantation; placement and fixation of the allograft; and closure of the wound.Range of motion is tested post-implantation to confirm proper placement.
Example 1: A 45-year-old male patient presents with chronic knee pain and limited range of motion due to a large osteochondral defect in the medial femoral condyle.Open surgical repair with an allograft is performed., A 28-year-old female patient sustained a significant osteochondral injury to the lateral femoral condyle during a skiing accident. Open surgery with allograft implantation is indicated due to the size and location of the lesion., A 60-year-old male patient with osteoarthritis and a history of prior knee surgeries has developed a symptomatic osteochondral defect in the patella. Open surgical repair with allograft is chosen to address the defect and improve functional outcome.
** The maximum unit of service (MUE) for code 27415 is 1. Payers adhering to Medicare guidelines will only reimburse the code once, regardless of the number of lesions addressed.In such cases, modifier 22 may be appended to indicate increased complexity.
- Revenue Code: P3D (MAJOR PROCEDURE, ORTHOPEDIC - OTHER)
- RVU: Information not available in provided text.Refer to the current year's CPT codebook or a reliable medical billing resource for RVU data.
- Global Days: Information not available in provided text.The global period will vary depending on payer and other factors. Consult payer guidelines.
- Payment Status: Active
- Modifier TC rule: Information not applicable to this code.
- Fee Schedule: Information not available in provided text.Refer to historical CPT codebooks or billing resources.
- Specialties:Orthopedic Surgery
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center, Hospital Outpatient