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Official Description

Excision or curettage of bone cyst or benign tumor of femur;

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

The CPT® Code 27355 refers to the excision or curettage of a bone cyst or benign tumor located in the femur, which is the long bone in the thigh. A bone cyst is defined as a fluid-filled space within the bone, and it can vary in type. One common type is the unicameral or simple bone cyst, which is generally considered a benign lesion. Another type, the aneurysmal bone cyst, is characterized by vascular tissue surrounding a blood-filled cystic lesion. In addition to cysts, there are various benign bone tumors, such as giant cell tumors, chondromyxoid fibromas, and enchondromas, which may also necessitate surgical intervention. The procedure associated with CPT® Code 27355 involves making an incision over the lesion site on the femoral shaft or distal femur, followed by dissection of the soft tissues to expose the femur. If a cystic lesion is identified, the surgeon incises the bone to create a window, allowing access to the cyst. The fluid within the cyst is aspirated for laboratory analysis. A curette is then used to remove the lining of the cystic cavity completely. Alternatively, if a benign tumor is present, the lesion is excised along with a margin of surrounding healthy bone. This procedure is critical for addressing both cystic lesions and benign tumors in the femur, ensuring that the affected area is treated effectively while minimizing the risk of recurrence.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The procedure described by CPT® Code 27355 is indicated for the treatment of specific conditions affecting the femur, particularly:

  • Bone Cyst: A fluid-filled space within the bone that may require intervention due to size, symptoms, or risk of complications.
  • Benign Tumor: Non-cancerous growths in the femur, such as giant cell tumors, chondromyxoid fibromas, and enchondromas, that may necessitate excision to alleviate symptoms or prevent further complications.

2. Procedure

The procedure for CPT® Code 27355 involves several critical steps to ensure effective treatment of the bone cyst or benign tumor:

  • Step 1: Incision and Exposure An incision is made in the skin directly over the site of the lesion located in the femoral shaft or distal femur. This initial step is crucial for accessing the underlying bone and lesion.
  • Step 2: Dissection of Soft Tissues The surgeon carefully dissects the soft tissues surrounding the femur to expose the bone adequately. This dissection must be performed with precision to avoid damaging surrounding structures.
  • Step 3: Accessing the Cystic Lesion If a cystic lesion is present, the surgeon incises the bone to create a window that allows access to the cyst. This step is essential for the subsequent aspiration of the cystic fluid.
  • Step 4: Aspiration of Cystic Fluid The fluid within the cyst is aspirated and sent to the laboratory for analysis. This analysis can provide important information regarding the nature of the cyst.
  • Step 5: Curettage of the Cystic Lining A curette is inserted through the bone window to completely remove the lining of the cystic cavity. This thorough curettage is vital to minimize the risk of recurrence.
  • Step 6: Excision of Benign Tumor (if applicable) In cases where a benign tumor is present, the lesion is excised along with a margin of surrounding healthy bone. This excision is performed to ensure complete removal of the tumor and reduce the likelihood of regrowth.

3. Post-Procedure

After the procedure associated with CPT® Code 27355, post-operative care is essential for optimal recovery. Patients may be monitored for any signs of complications, such as infection or excessive bleeding. Pain management strategies will be implemented to ensure patient comfort. Depending on the extent of the procedure and the individual patient's condition, rehabilitation may be necessary to restore function and strength in the affected limb. Follow-up appointments will be scheduled to assess healing and determine if any further interventions are required. Additionally, if a bone graft or internal fixation is performed in conjunction with this procedure, specific post-operative care instructions related to those interventions will also be provided.

Short Descr REMOVE FEMUR LESION
Medium Descr EXCISION/CURETTAGE CYST/TUMOR FEMUR
Long Descr Excision or curettage of bone cyst or benign tumor of femur;
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 Hospital Part B services paid through a comprehensive APC
ASC Payment Indicator Surgical procedure on ASC list in CY 2007; payment based on OPPS relative payment weight.
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) P5B - Ambulatory procedures - musculoskeletal
MUE 1
CCS Clinical Classification 142 - Partial excision bone

This is a primary code that can be used with these additional add-on codes.

27358 Addon Code MPFS Status: Active Code APC N ASC N1 Illustration for Code Excision or curettage of bone cyst or benign tumor of femur; with internal fixation (List in addition to code for primary procedure)
AS Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery
RT Right side (used to identify procedures performed on the right side of the body)
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).
AG Primary physician
GC This service has been performed in part by a resident under the direction of a teaching physician
LT Left side (used to identify procedures performed on the left side of the body)
SG Ambulatory surgical center (asc) facility service
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
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2010-01-01 Changed Code description changed.
Pre-1990 Added Code added.
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