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The CPT® Code 27358 refers to the excision or curettage of a bone cyst or benign tumor located in the femur, accompanied by internal fixation. A bone cyst is defined as a fluid-filled cavity within the bone, which can vary in type. The unicameral or simple bone cyst is a common benign lesion, while the aneurysmal bone cyst is less common and characterized by vascular tissue surrounding a blood-filled cystic lesion. Additionally, benign bone tumors can include various forms such as giant cell tumors, chondromyxoid fibromas, and enchondromas. The procedure involves making an incision over the affected area of the femur, followed by dissection of the soft tissues to expose the bone. If a cystic lesion is identified, a window is created in the bone to access the cyst, allowing for fluid aspiration and laboratory analysis. The cyst lining is then removed through curettage, or the lesion may be excised along with a margin of healthy bone. Following these steps, internal fixation is performed to stabilize the femur, particularly if the defect is significant in size or location. This fixation is achieved using plates, screws, or other devices to prevent potential fractures and to secure any bone grafts that may have been placed during the procedure.
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The procedure associated with CPT® Code 27358 is indicated for the treatment of specific conditions related to bone cysts or benign tumors of the femur. The following are the explicitly provided indications for this procedure:
The procedure for CPT® Code 27358 involves several critical steps that ensure the effective treatment of bone cysts or benign tumors in the femur. The following procedural steps are outlined:
After the completion of the procedure associated with CPT® Code 27358, post-procedure care is essential for optimal recovery. Patients may be monitored for any signs of complications, such as infection or improper healing. Pain management strategies will be implemented to ensure patient comfort. Rehabilitation may be necessary to restore function and strength to the affected limb, and follow-up appointments will be scheduled to assess the healing process and the effectiveness of the internal fixation. The physician will provide specific instructions regarding weight-bearing activities and any restrictions to promote proper recovery.
| Short Descr | REMOVE FEMUR LESION/FIXATION | Medium Descr | EXCISION/CURETTAGE CYST/TUMOR FEMUR INT FIXATION | Long Descr | Excision or curettage of bone cyst or benign tumor of femur; with internal fixation (List in addition to code for primary procedure) | Status Code | Active Code | Global Days | ZZZ - Code Related to Another Service | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 0 - No payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | 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) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Items and Services Packaged into APC Rates | ASC Payment Indicator | Packaged service/item; no separate payment made. | 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 an add-on code that must be used in conjunction with one of these primary codes.
| 27355 | MPFS Status: Active Code APC J1 ASC A2 Illustration for Code Excision or curettage of bone cyst or benign tumor of femur; | 27356 | MPFS Status: Active Code APC J1 ASC J8 Illustration for Code Excision or curettage of bone cyst or benign tumor of femur; with allograft | 27357 | MPFS Status: Active Code APC J1 ASC J8 CPT Assistant Article Illustration for Code Excision or curettage of bone cyst or benign tumor of femur; with autograft (includes obtaining graft) |
| 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. | 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) |
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| Pre-1990 | Added | Code added. |
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