2025 CPT code 27759
(Active) Effective Date: N/A Revision Date: N/A Surgery - Fracture and/or Dislocation Procedures on the Leg (Tibia and Fibula) and Ankle Joint Musculoskeletal System Feed
Treatment of tibial shaft fracture (with or without fibular fracture) using an intramedullary implant, with or without interlocking screws and/or cerclage.
Modifiers such as 51 (multiple procedures), 54 (surgical care only), 59 (distinct procedural service), and 76 (repeat procedure) may be applicable depending on the circumstances.
The medical necessity for this procedure is established by the presence of a displaced tibial shaft fracture causing pain, functional impairment, or risk of complications such as nonunion or malunion. The severity and displacement of the fracture, as well as the patient's overall health and functional status, determine the need for surgical intervention.
The orthopedic surgeon is responsible for the entire procedure, from pre-operative planning to post-operative care within the global period. This includes making the incision, manipulating the fracture fragments, inserting the intramedullary device, potentially adding screws or cerclage wire, irrigating the wound, controlling bleeding, and closing the incision.Post-operative monitoring within the 90-day global period is also the responsibility of the surgeon.
In simple words: This code describes a surgery to fix a broken tibia (shin bone), which might also include a break in the smaller bone next to it.A metal rod is inserted into the bone to hold it together while it heals, and sometimes extra screws or wires are used to make sure it stays stable.If the other bone is also broken, that's included in this procedure – you don't need a separate code for it.
This CPT code encompasses the surgical treatment of a tibial shaft fracture, which may or may not involve a fibular fracture.The procedure involves inserting an intramedullary (IM) rod or nail into the medullary canal of the tibia.Interlocking screws and/or cerclage wiring may be used for additional stabilization.Treatment of an associated fibular fracture is included; separate coding for the fibular fracture is not necessary. The procedure aims to restore proper alignment, prevent displacement, and alleviate pain during fracture healing.
Example 1: A 35-year-old male sustains a closed tibial shaft fracture in a motor vehicle accident.The fracture is comminuted (broken into multiple pieces). The surgeon performs an open reduction internal fixation (ORIF) with intramedullary nailing and interlocking screws using CPT code 27759., A 22-year-old female sustains a tibial shaft fracture with an associated fibular fracture during a skiing accident. The fracture is treated with intramedullary nailing and cerclage wiring. CPT code 27759 is used, as treatment of the fibular fracture is included., A 60-year-old male with osteoporosis experiences a pathologic tibial shaft fracture. The surgeon performs an ORIF with intramedullary nailing and interlocking screws.Post-operative care, including cast changes and follow-up appointments within the global period, are covered under CPT code 27759.
Pre-operative imaging (X-rays, CT scans), operative report detailing the surgical technique (type of intramedullary implant used, screw placement, cerclage wiring), intra-operative radiographs confirming reduction, post-operative imaging to assess healing, and all relevant progress notes.
** The global period for this procedure is 90 days.Additional procedures performed during or after the global period, such as cast changes or additional imaging, may be billed separately.Documentation must clearly support the medical necessity and the type of procedure performed.
- Revenue Code: P3D (MAJOR PROCEDURE, ORTHOPEDIC - OTHER)
- RVU: This information varies based on location, payer, and other factors. Consult a relevant fee schedule for the most accurate RVU data.
- Global Days: 90 days
- Payment Status: Active
- Modifier TC rule: A Technical Component (TC) modifier is not typically applicable to this code as it represents a complete surgical procedure.
- Fee Schedule: Fee schedules vary by payer and location.Historical data can be obtained through a provider's billing system or relevant fee schedule databases.
- Specialties:Orthopedic Surgery
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center, Outpatient Hospital