2025 CPT code 27637
(Active) Effective Date: N/A Revision Date: N/A Surgery - Excision and Biopsy Musculoskeletal System Feed
Excision or curettage of bone cyst or benign tumor of the tibia or fibula, with autograft (includes obtaining graft).
Modifiers may be applicable in certain circumstances (e.g., 51 for multiple procedures, 62 for two surgeons, 76 for a repeat procedure).
Medical necessity is established by the presence of a symptomatic bone cyst or benign tumor that impairs function, causes pain, or poses a risk of pathological fracture.Imaging studies must demonstrate the need for surgical intervention.
The orthopedic surgeon is primarily responsible for this procedure, which requires expertise in bone surgery, tissue grafting, and wound closure.
- Musculoskeletal System
- Musculoskeletal System > Surgical Procedures on the Musculoskeletal System > Excision and Biopsy
In simple words: The doctor removes a bone cyst or non-cancerous tumor from the tibia or fibula (leg bones below the knee) and fills the empty space with a piece of bone taken from another part of the patient's own body.
This CPT code encompasses the surgical excision or curettage of a bone cyst or benign tumor located in the tibia or fibula. The procedure includes the harvesting and implantation of an autograft to repair the resulting bone defect.The autograft is obtained from another site within the patient's body.The code incorporates all aspects of the procedure, including obtaining the graft, and does not allow separate reporting for graft harvesting.
Example 1: A 35-year-old patient presents with a symptomatic bone cyst in the tibia.The surgeon performs an excision, curettage, and autograft reconstruction., A 16-year-old patient sustains a tibial fracture and develops a non-union with a significant bone defect.The surgeon performs excision, curettage, and autograft to facilitate healing., A 60-year-old patient presents with a benign tumor in the fibula causing pain and instability. The surgeon performs an excision, curettage, and autograft to resect the tumor and restore bone integrity.Post-operative physical therapy is ordered.
* Preoperative diagnostic imaging (X-ray, MRI) demonstrating the bone lesion.* Operative report detailing the surgical technique, including the site and size of the lesion, excision method (curettage, excision), the source and amount of autograft used, and wound closure.* Pathology report confirming the benign nature of the lesion.* Postoperative imaging to assess the graft integration and healing.* Progress notes documenting pain management and rehabilitation progress.
** This code should only be used when an autograft is used.If an allograft is used, code 27638 should be reported instead.Ensure the documentation clearly supports the medical necessity of the procedure and the use of an autograft.
- Revenue Code: 5115 (Example - Level 5 MSK Procedures.Revenue codes can vary by payer.)
- RVU: RVUs will vary based on geographic location and other factors; consult your specific payer's fee schedule.
- Global Days : The global period for this procedure would be determined by the payer's guidelines and may vary.
- Payment Status: Active
- Modifier TC rule: A technical component (TC) modifier is not applicable to this code.
- Fee Schedule : Historical fee schedule data can vary based on payer and location. Consult your specific payer for this information.
- Specialties:Orthopedic Surgery
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center, Outpatient Hospital