2025 CPT code 27641
(Active) Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures on the Musculoskeletal System Musculoskeletal System Feed
Partial excision (craterization, saucerization, or diaphysectomy) of bone (e.g., osteomyelitis); fibula.
Modifiers may apply depending on the circumstances, such as modifier 51 for multiple procedures, modifier 62 for two surgeons, and others as clinically indicated.
Medical necessity is established by the presence of confirmed osteomyelitis of the fibula resistant to medical management. Documentation must support the need for surgical intervention and the specific technique employed.
The surgeon is responsible for the complete procedure, including incision, dissection, bone removal, wound irrigation, possible bone grafting, and wound closure.
In simple words: The doctor removes a diseased part of the fibula bone (in the lower leg) to treat a bone infection (osteomyelitis). This might involve scooping out the infection, leaving a small hole, or removing a section of the bone. The wound is then cleaned and closed.
This CPT code encompasses the partial surgical removal of a diseased portion of the fibula bone to address osteomyelitis.The procedure involves either craterization/saucerization (scooping out diseased bone, leaving a depression) or diaphysectomy (removing the middle portion of the bone).The surgeon makes an incision, dissects through tissue layers, retracts soft tissues, incises and reflects the periosteum, removes diseased bone (using a burr for craterization/saucerization), potentially fills the space with healthy bone, replaces the periosteum, washes the area with antibiotic solution, may place antibiotic beads, and closes the wound in layers.Simple or intermediate closure is included. Complex repairs, bone grafts, or additional procedures are reported separately.
Example 1: A patient presents with chronic osteomyelitis of the fibula. The surgeon performs a saucerization to remove the infected bone, leaving a saucer-shaped depression. The wound is closed primarily., A patient with acute osteomyelitis of the fibula requires a diaphysectomy to remove a segment of the infected bone.The defect is filled with an autologous bone graft harvested from the iliac crest. The wound is closed in layers., A patient suffers a severe fibula fracture with subsequent osteomyelitis.The surgeon performs a partial excision, removing a large portion of infected bone using a combination of craterization and diaphysectomy techniques.The resulting defect is packed with antibiotic beads and the wound is left open to heal by secondary intention.
Preoperative and postoperative diagnosis, operative report detailing the technique used (craterization, saucerization, diaphysectomy), bone removed, use of bone graft, antibiotic bead placement (if any), wound closure method, and any complications.Imaging studies (X-rays, CT scans) to show the extent of osteomyelitis before and after the procedure.
** This code is used for partial excision of bone to treat osteomyelitis in the fibula.Careful consideration should be given to the amount of bone removed and the method of closure when selecting this code.If there are other procedures performed during the same operative session, they should be coded separately.
- Revenue Code: P5B (AMBULATORY PROCEDURES - MUSCULOSKELETAL)
- Payment Status: Active
- Modifier TC rule: Not applicable.
- Specialties:Orthopedic Surgery
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center, Outpatient Hospital