2025 CPT code 27635
(Active) Effective Date: N/A Revision Date: N/A Surgery - Excision Procedures on the Leg (Tibia and Fibula) and Ankle Joint Musculoskeletal System Feed
Excision or curettage of a bone cyst or benign tumor from the tibia or fibula.
Modifiers 50 (bilateral procedure), 51 (multiple procedures), and 76 (repeat procedure) may be applicable depending on the circumstances.
Medical necessity is established when the bone cyst or benign tumor causes significant pain, functional impairment, or risk of infection or fracture. The proposed procedure should be the most appropriate and effective treatment option to improve the patient's symptoms and quality of life.Documentation must support the necessity.
The orthopedic surgeon or qualified healthcare professional is responsible for performing the surgical excision, including incision, dissection, periosteal elevation, curettage or excision of the lesion, bone smoothing, irrigation, and wound closure.
- Musculoskeletal System
- Surgical Procedures on the Musculoskeletal System > Excision Procedures on the Leg (Tibia and Fibula) and Ankle Joint
In simple words: The doctor removes a cyst or non-cancerous growth from the tibia or fibula (bones in the lower leg) to relieve pain and prevent infection. This involves making a cut, removing the growth, and closing the wound.
This code describes the surgical removal of a bone cyst or benign tumor from the tibia or fibula.The procedure involves making an incision, dissecting through subcutaneous tissues and muscle, incising and reflecting the periosteum, excising the cyst using a burr, smoothing the bone surface, irrigating the area, and closing the wound in layers.The procedure aims to alleviate pain, prevent infection, and address any functional deficits caused by the lesion.Use of autograft or allograft should be coded separately using codes 27637 and 27638 respectively.
Example 1: A 45-year-old patient presents with a painful, palpable bone cyst in the tibia, diagnosed by imaging.The surgeon performs an excision of the cyst using code 27635. , A 20-year-old patient suffers a tibial fracture with a resulting bone cyst formation.After fracture healing, the cyst is surgically removed using code 27635. , A 60-year-old patient has a benign bone tumor in their fibula that is causing pain and limited mobility.The surgeon excises the tumor using code 27635.
* Preoperative and postoperative diagnoses.* Imaging studies (X-rays, CT, MRI) confirming the lesion's location and size.* Operative report detailing the procedure, including size and nature of the lesion, and surgical technique.* Pathology report confirming benign nature of the excised tissue.* Any complications encountered during or after surgery.
** Careful documentation is crucial for accurate coding and reimbursement.Always consult the most current CPT codebook and payer guidelines.Be aware of potential MUE edits.
- Revenue Code: P5B (Ambulatory Procedures - Musculoskeletal)
- RVU: Consult the Medicare Physician Fee Schedule (MPFS) for the most current RVU and reimbursement information.
- Global Days : The global period for this procedure should be determined based on the specific circumstances of the case and payer guidelines.Additional procedures performed within the global period should be coded separately, as appropriate.
- Payment Status: Active
- Modifier TC rule: Not applicable.
- Fee Schedule : Consult the Medicare Physician Fee Schedule (MPFS) for historical fee schedule information.
- Specialties:Orthopedic Surgery
- Place of Service:Office, Ambulatory Surgical Center, Inpatient Hospital