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Official Description

Osteotomy and transfer of greater trochanter of femur (separate procedure)

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

The procedure described by CPT® Code 27140 refers to an osteotomy and transfer of the greater trochanter of the femur, which is classified as a separate procedure. This surgical intervention is primarily aimed at enhancing the function of the hip's abductor muscles and ensuring appropriate soft tissue tension, particularly in patients who have experienced prior injuries or surgical interventions involving the hip joint. The greater trochanter is a prominent bony structure located on the femur, serving as an important attachment point for muscles that facilitate hip movement. The procedure involves making a skin incision over the lateral side of the hip, followed by careful dissection of the soft tissues to expose the greater trochanter. Once exposed, the surgeon marks the site for the osteotomy and performs a series of precise cuts around the greater trochanter to completely detach it from the femur. After the osteotomy, the greater trochanter is repositioned to optimize its function and is secured in place using various fixation methods, such as wires, cables, or a plate and screw system. Finally, the surgeon checks the hip's range of motion to ensure proper alignment and function before closing the incisions in layers to promote healing.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The osteotomy and transfer of the greater trochanter of the femur is indicated for patients who present with specific conditions or symptoms that necessitate this surgical intervention. The following are the primary indications for performing this procedure:

  • Improvement of Abductor Function This procedure is performed to enhance the function of the hip abductor muscles, which are crucial for stabilizing the pelvis during walking and other activities.
  • Previous Hip Joint Injury Patients who have sustained injuries to the hip joint may require this procedure to restore proper function and alignment of the greater trochanter.
  • Prior Surgical Interventions Individuals who have undergone previous surgeries on the hip joint may benefit from this procedure to correct any resultant functional deficits or to re-establish proper soft tissue tension.

2. Procedure

The procedure for the osteotomy and transfer of the greater trochanter involves several critical steps that ensure the successful execution of the surgery. Each step is designed to facilitate the proper detachment and repositioning of the greater trochanter.

  • Step 1: Skin Incision The surgical process begins with the creation of a skin incision over the lateral aspect of the hip joint. This incision provides access to the underlying structures and is carefully planned to minimize trauma to surrounding tissues.
  • Step 2: Soft Tissue Dissection Following the incision, the surgeon meticulously dissects the soft tissues to expose the greater trochanter. This step requires precision to avoid damaging important nerves and blood vessels in the area.
  • Step 3: Marking the Osteotomy Site Once the greater trochanter is adequately exposed, the surgeon marks the planned site for the osteotomy. This marking is crucial for guiding the subsequent cuts in the femur.
  • Step 4: Performing the Osteotomy A series of cuts are then made around the greater trochanter to completely sever it from the femur. This step is performed with great care to ensure that the osteotomy is clean and precise.
  • Step 5: Repositioning the Greater Trochanter After the osteotomy is completed, the greater trochanter is repositioned on the femur. This repositioning is essential for restoring proper function and alignment.
  • Step 6: Securing the Greater Trochanter The repositioned greater trochanter is secured using various fixation methods, which may include wires, cables, and/or a plate and screw fixation device. This stabilization is vital for ensuring that the greater trochanter remains in the correct position during the healing process.
  • Step 7: Checking Hip Range of Motion Once the fixation is in place, the surgeon checks the hip's range of motion to confirm that the greater trochanter is properly aligned and functioning as intended.
  • Step 8: Closing the Incisions Finally, the incisions are closed in layers to promote optimal healing and minimize the risk of complications.

3. Post-Procedure

After the osteotomy and transfer of the greater trochanter, patients can expect specific post-procedure care and considerations. It is essential to monitor the surgical site for any signs of infection or complications. Patients may be advised to follow a rehabilitation program that includes physical therapy to restore strength and mobility in the hip joint. The recovery process may vary depending on individual circumstances, but it is crucial to adhere to the surgeon's guidelines regarding weight-bearing activities and movement restrictions to ensure proper healing. Regular follow-up appointments will be necessary to assess the healing progress and to make any adjustments to the rehabilitation plan as needed.

Short Descr TRANSPLANT FEMUR RIDGE
Medium Descr OSTEOTOMY&TRANSFER GREATER TROCHANTER SPX
Long Descr Osteotomy and transfer of greater trochanter of femur (separate procedure)
Status Code Active Code
Global Days 090 - Major Surgery
PC/TC Indicator (26, TC) 0 - Physician Service Code
Multiple Procedures (51) 2 - Standard payment adjustment rules for multiple procedures apply.
Bilateral Surgery (50) 1 - 150% payment adjustment for bilateral procedures applies.
Physician Supervisions 09 - Concept does not apply.
Assistant Surgeon (80, 82) 2 - Payment restriction for assistants at surgery does not apply to this procedure...
Co-Surgeons (62) 1 - Co-surgeons could be paid, though supporting documentation is required...
Team Surgery (66) 0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator Inpatient Procedures, not paid under OPPS
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) P3D - Major procedure, orthopedic - other
MUE 1
CCS Clinical Classification 161 - Other OR therapeutic procedures on bone
22 Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service.
50 Bilateral procedure: unless otherwise identified in the listings, bilateral procedures that are performed at the same session, should be identified by adding modifier 50 to the appropriate 5 digit code. note: this modifier should not be appended to designated "add-on" codes (see appendix d).
51 Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d).
58 Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78.
59 Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25.
78 Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.)
79 Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.)
80 Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s).
82 Assistant surgeon (when qualified resident surgeon not available): the unavailability of a qualified resident surgeon is a prerequisite for use of modifier 82 appended to the usual procedure code number(s).
AS Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery
GC This service has been performed in part by a resident under the direction of a teaching physician
GY Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit
LT Left side (used to identify procedures performed on the left side of the body)
RT Right side (used to identify procedures performed on the right side of the body)
XS Separate structure, a service that is distinct because it was performed on a separate organ/structure
XU Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service
Date
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Notes
2002-01-01 Changed Code description changed.
Pre-1990 Added Code added.
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