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The CPT® Code 27356 refers to the excision or curettage of a bone cyst or benign tumor located in the femur, specifically when this procedure is accompanied by the use of an allograft. A bone cyst is defined as a fluid-filled cavity within the bone, which can vary in type and presentation. One of the most common forms is the unicameral or simple bone cyst, recognized as a benign lesion that typically does not pose significant health risks. Another type, the aneurysmal bone cyst, is characterized by a vascular structure 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 necessitate surgical intervention. The procedure begins with an incision made over the affected area of the femur, allowing access to the underlying soft tissues. These tissues are carefully dissected to expose the femur, where the presence of a cystic lesion may require the creation of a window in the bone. This window allows for the aspiration of fluid, which is then sent for laboratory analysis. The next step involves the use of a curette 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 healthy bone to ensure complete removal. In the case of CPT® Code 27356, after the lesion has been either curetted or excised, the resulting defect in the bone is filled with donor bone tissue, known as an allograft. This allograft serves to promote healing and restore structural integrity to the femur. The procedure is critical for addressing both the immediate concerns of the cyst or tumor and the long-term health of the bone, ensuring that the area is adequately supported during the recovery process.
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The procedure associated with CPT® Code 27356 is indicated for the treatment of specific conditions affecting the femur, particularly when a bone cyst or benign tumor is present. The following are the explicitly provided indications for this procedure:
The procedure for CPT® Code 27356 involves several critical steps to ensure the effective removal of the bone cyst or benign tumor and the subsequent packing of the defect with an allograft. The following procedural steps are outlined:
Following the procedure associated with CPT® Code 27356, post-operative care is essential for optimal recovery. Patients may be monitored for any signs of complications, such as infection or improper healing. The use of pain management strategies may be necessary to ensure patient comfort during the recovery phase. Additionally, follow-up appointments will be scheduled to assess the healing of the surgical site and the integration of the allograft into the femur. Rehabilitation may be recommended to restore function and strength to the affected limb, depending on the extent of the procedure and the patient's overall health status.
| Short Descr | REMOVE FEMUR LESION/GRAFT | Medium Descr | EXCISION/CURETTAGE CYST/TUMOR FEMUR W/ALLOGRAFT | Long Descr | Excision or curettage of bone cyst or benign tumor of femur; with allograft | 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 | Device-intensive procedure added to ASC list in CY 2008 or later; paid at adjusted rate. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P3D - Major procedure, orthopedic - other | 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) |
| 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). | 52 | Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use). | 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. | 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). | 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 | 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 |
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| Pre-1990 | Added | Code added. |
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