2025 CPT code 27472
(Active) Effective Date: N/A Revision Date: N/A Surgery - Musculoskeletal System Feed
Repair of femur nonunion or malunion, distal to head and neck, with iliac or other autogenous bone graft.
Modifiers may be applicable in specific scenarios (e.g., 54 for surgical care only, 76 for repeat procedure by same surgeon, etc.).Refer to current CPT modifier guidelines for appropriate usage.
Medical necessity for 27472 must be supported by documentation demonstrating the presence of a nonunion or malunion causing functional impairment or pain that has failed conservative management.The documentation should clearly indicate why surgical intervention with bone grafting is necessary for the patient's well-being.
The surgeon is responsible for the entire surgical procedure, from incision to wound closure, including obtaining and applying the bone graft. This requires specialized orthopedic surgical training and expertise.
In simple words: This surgery fixes a broken thigh bone that hasn't healed correctly or at all. The surgeon uses a bone graft from your hip or another area to help the bone mend.
This procedure involves the repair of a nonunion or malunion of the femur, distal to the femoral head and neck, using an autogenous bone graft from the iliac crest or another suitable donor site. The procedure includes obtaining the graft.The surgeon makes an incision, exposes the fracture site, removes any existing hardware, realigns the bone segments, and then secures the graft to promote bone healing. The wound is then closed in layers.
Example 1: A patient with a nonunion of the femoral shaft following a car accident undergoes open reduction internal fixation with an iliac bone graft (27472)., A patient with a painful femoral malunion undergoes corrective osteotomy and bone grafting using autologous bone from the iliac crest (27472)., A patient with a previous femoral fracture that healed with significant angulation requires surgical correction and bone grafting to restore proper alignment and function (27472).
Documentation should include details of the fracture, evidence of nonunion or malunion (e.g., imaging studies, physical exam findings), type of bone graft used, surgical technique employed, and any complications encountered.Preoperative and postoperative diagnoses should also be clearly documented.
** The information provided is current as of December 1st, 2024, and may be subject to change. Always consult the most up-to-date CPT coding manuals and payer guidelines for accurate coding and billing practices.For precise RVU information and payer-specific rules, it is recommended to use iFrameAI.
- Global Days : Global days vary depending on payer policies.
- Payment Status: Active
- Modifier TC rule: No specific TC modifier rules apply to 27472, but appropriate modifiers should be used if a separate physician performs a portion of the service.
- Fee Schedule : Fee schedules vary by payer and location. Consult historical fee data from CMS and other payers for specific reimbursement information.
- Specialties:Orthopedic Surgery
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center