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The CPT® Code 27357 refers to the procedure of excision or curettage of a bone cyst or benign tumor located in the femur, accompanied by the use of an autograft, which includes the process of obtaining the graft. A bone cyst is defined as a fluid-filled cavity within the bone, and it can manifest in various forms. One prevalent type is the unicameral or simple bone cyst, which is generally considered benign. Another type, the aneurysmal bone cyst, is characterized by vascular tissue that surrounds a blood-filled cystic lesion. In addition to cysts, there are several types of benign bone tumors, such as giant cell tumors, chondromyxoid fibromas, and enchondromas, which may also necessitate surgical intervention. During the procedure associated with CPT® Code 27357, an incision is made over the affected area of the femur, typically in the femoral shaft or distal femur. The soft tissues are carefully dissected to expose the femur. If a cystic lesion is identified, the bone is incised to create a window that allows access to the cyst. The fluid within the cyst is aspirated for laboratory analysis. A curette is then utilized to remove the lining of the cystic cavity completely. In cases where benign tumors are present, the lesion is excised along with a margin of healthy bone to ensure complete removal. Following the excision or curettage, the physician obtains healthy bone tissue, known as an autograft, either from the same surgical site or from a separate location, such as the iliac crest. This autograft is then packed into the defect created in the femur, promoting healing and stability. This procedure is critical for addressing bone cysts and benign tumors while ensuring the integrity of the femur is maintained.
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The procedure associated with CPT® Code 27357 is indicated for the treatment of specific conditions affecting the femur, particularly:
The procedure for CPT® Code 27357 involves several critical steps to ensure the effective treatment of bone cysts or benign tumors in the femur:
After the completion of the procedure associated with CPT® Code 27357, post-operative care is essential for optimal recovery. Patients are typically monitored for any signs of complications, such as infection or excessive bleeding. Pain management strategies are implemented to ensure patient comfort. The surgical site may require dressing changes, and patients are advised on activity restrictions to promote healing. Follow-up appointments are scheduled to assess the healing process and to determine if any further interventions, such as internal fixation, are necessary, especially if the size or location of the defect warrants additional stabilization.
| Short Descr | REMOVE FEMUR LESION/GRAFT | Medium Descr | EXCISION/CURETTAGE CYST/TUMOR FEMUR W/AUTOGRAFT | Long Descr | Excision or curettage of bone cyst or benign tumor of femur; with autograft (includes obtaining graft) | 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) |
| AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | 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) | 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. | 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). | GC | This service has been performed in part by a resident under the direction of a teaching physician |
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| Pre-1990 | Added | Code added. |
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