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2025 CPT code 27416

Open osteochondral autograft transplantation in the knee (mosaicplasty), including autograft harvesting.

Follow all applicable CPT guidelines for musculoskeletal surgery. Accurate documentation is crucial for correct code assignment. The size and number of grafts are not explicitly coded but must be detailed in the operative report.

Modifiers may be applicable depending on the circumstances of the procedure. Consult the CPT manual and payer guidelines for appropriate modifier use (e.g., 51 for multiple procedures, 76 for repeat procedure).

Medical necessity is established through the presence of symptomatic, significant cartilage defects that impair joint function and cause pain.Conservative treatment modalities must have failed to yield satisfactory results before surgical intervention with autograft transplantation is considered medically necessary.

The orthopedic surgeon is responsible for pre-operative planning, the surgical procedure itself (incisions, graft harvesting, graft placement, wound closure), and post-operative care. Anesthesiologist is responsible for providing anesthesia.

IMPORTANT:Do not report 27416 with 27415, 29870, 29871, 29875, 29884 (same session) or 29874, 29877, 29879, 29885-29887 (same compartment). For arthroscopic osteochondral autograft, use 29866. For osteochondral xenograft, use 0737T.

In simple words: This code covers a knee surgery where the doctor takes small pieces of bone and cartilage from a healthy part of the knee and uses them to repair damaged cartilage in another area of the knee.

This CPT code, 27416, describes the surgical procedure involving the harvesting of autologous osteochondral grafts from a non-weight-bearing area of the knee joint, typically the femoral condyles, and their subsequent transplantation to a damaged articular cartilage area within the same knee.The procedure includes all aspects from incision and graft harvesting to graft placement and wound closure.It is commonly referred to as mosaicplasty.

Example 1: A 35-year-old male presents with significant cartilage damage in the medial femoral condyle due to a previous sports injury. The surgeon performs an open osteochondral autograft transplantation using 27416 to repair the damaged cartilage., A 48-year-old female experiences chronic knee pain resulting from osteoarthritis.The surgeon determines that mosaicplasty is appropriate and performs the procedure, coding it with 27416, to address the focal cartilage defects., A 22-year-old athlete sustains a significant osteochondral lesion in the lateral femoral condyle during a sporting event. Open surgery is necessary, and the physician uses 27416 to bill for the autograft procedure.

Preoperative imaging (X-ray, MRI) showing the location and extent of cartilage damage. Operative report detailing the harvest site, number and size of grafts, recipient site preparation, and technique used for graft fixation. Postoperative imaging to confirm graft placement and assess healing.

** This procedure is often performed arthroscopically (code 29866).The choice between open and arthroscopic techniques depends on the surgeon's assessment of the patient's specific needs and the extent of cartilage damage.

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