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Official Description

Open treatment of femoral supracondylar or transcondylar fracture without intercondylar extension, includes internal fixation, when performed

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

The CPT® Code 27511 refers to the open treatment of a femoral supracondylar or transcondylar fracture that does not extend into the intercondylar region. In simpler terms, this procedure addresses fractures located just above the knee joint, specifically in the distal femur, which is the thigh bone near the knee. The two types of fractures described are supracondylar fractures, which occur just above the bony projections known as the lateral and medial epicondyles, and transcondylar fractures, which occur through these epicondyles. These fractures can be serious and may require surgical intervention to ensure proper healing and alignment of the bone. During the procedure, an incision is made on the outer side of the distal femur, allowing access to the fracture site. The surgical team carefully dissects through the surrounding tissue to reach the bone, controlling any bleeding that may occur. The fracture is then treated using various internal fixation methods, which are devices that help stabilize the bone fragments during the healing process. The choice of fixation device depends on the specific characteristics of the fracture. This procedure is critical for restoring the normal anatomy of the femur and ensuring that the patient can regain full function of the knee joint following recovery.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The open treatment of femoral supracondylar or transcondylar fractures is indicated in the following situations:

  • Supracondylar Fractures Fractures occurring just above the epicondyles of the femur.
  • Transcondylar Fractures Fractures that traverse through the epicondyles of the femur.
  • Fractures Without Intercondylar Extension Cases where the fracture does not extend into the intercondylar region, allowing for treatment under CPT® Code 27511.

2. Procedure

The procedure for the open treatment of femoral supracondylar or transcondylar fractures involves several critical steps:

  • Incision and Exposure An incision is made over the lateral aspect of the distal femur, extending over the articular surface of the knee. This incision allows access to the fracture site. The surrounding tissue is carefully dissected down to the fascia lata, which is then split to facilitate further access.
  • Dissection of Muscle The surgical team approaches the distal segment of the femur by carefully dissecting the vastus lateralis muscle along its posterior aspect. This step is crucial for exposing the fracture site without causing unnecessary damage to surrounding tissues.
  • Control of Bleeding Any arterial bleeding encountered during the procedure is controlled using electrocautery and ligation of vessels. This ensures a clear surgical field and minimizes complications.
  • Fracture Exposure and Reduction The fracture site is exposed and cleared of any debris. The fracture in the supracondylar or transcondylar region is then reduced indirectly, which may involve the application of longitudinal traction or the use of a femoral distraction device to align the bone fragments properly.
  • Internal Fixation After the fracture is reduced, internal fixation is performed using devices selected based on the specific nature of the fracture. Options include low-contact dynamic compression (LC-DC) plates, dynamic condylar screws (DCS), condylar blade plates, condylar buttress plates, locking plates, T-buttress plates, intramedullary devices (nails or rods), or cannulated lag screws. The fixation devices are carefully chosen to avoid intersecting the fracture lines.
  • Verification of Reduction Once all fragments are secured with one or more fixation devices, X-rays are obtained to verify that anatomic reduction has been achieved, ensuring that the bone is properly aligned for optimal healing.

3. Post-Procedure

Post-procedure care for patients undergoing open treatment of femoral supracondylar or transcondylar fractures typically includes monitoring for complications such as infection or improper healing. Patients may be advised to limit weight-bearing activities on the affected leg during the initial recovery phase. Follow-up appointments are essential to assess healing through imaging studies and to adjust rehabilitation protocols as necessary. The overall goal of post-procedure care is to ensure proper recovery and restore function to the knee joint.

Short Descr TREATMENT OF THIGH FRACTURE
Medium Descr OPEN TX FEMORAL SUPRACONDYLAR FRACTURE W/O XTN
Long Descr Open treatment of femoral supracondylar or transcondylar fracture without intercondylar extension, includes internal fixation, when performed
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) 2 - Co-surgeons permitted and no documentation required if the two- specialty requirement is met.
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 146 - Treatment, fracture or dislocation of hip and femur
RT Right side (used to identify procedures performed on the right side of the body)
LT Left side (used to identify procedures performed on the left side of the body)
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
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).
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).
53 Discontinued procedure: under certain circumstances, the physician or other qualified health care professional may elect to terminate a surgical or diagnostic procedure. due to extenuating circumstances or those that threaten the well being of the patient, it may be necessary to indicate that a surgical or diagnostic procedure was started but discontinued. this circumstance may be reported by adding modifier 53 to the code reported by the individual for the discontinued procedure. note: this modifier is not used to report the elective cancellation of a procedure prior to the patient's anesthesia induction and/or surgical preparation in the operating suite. for outpatient hospital/ambulatory surgery center (asc) 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).
54 Surgical care only: when 1 physician or other qualified health care professional performs a surgical procedure and another provides preoperative and/or postoperative management, surgical services may be identified by adding modifier 54 to the usual procedure number.
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.
62 Two surgeons: when 2 surgeons work together as primary surgeons performing distinct part(s) of a procedure, each surgeon should report his/her distinct operative work by adding modifier 62 to the procedure code and any associated add-on code(s) for that procedure as long as both surgeons continue to work together as primary surgeons. each surgeon should report the co-surgery once using the same procedure code. if additional procedure(s) (including add-on procedure(s) are performed during the same surgical session, separate code(s) may also be reported with modifier 62 added. note: if a co-surgeon acts as an assistant in the performance of additional procedure(s), other than those reported with the modifier 62, during the same surgical session, those services may be reported using separate procedure code(s) with modifier 80 or modifier 82 added, as appropriate.
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).
81 Minimum assistant surgeon: minimum surgical assistant services are identified by adding modifier 81 to the usual procedure number.
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
AQ Physician providing a service in an unlisted health professional shortage area (hpsa)
CC Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed)
CR Catastrophe/disaster related
ET Emergency services
GV Attending physician not employed or paid under arrangement by the patient's hospice provider
GW Service not related to the hospice patient's terminal condition
Q6 Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area
U7 Medicaid level of care 7, as defined by each state
X4 Episodic/focused services: for reporting services by clinicians who provide focused care on particular types of treatment limited to a defined period and circumstance; the patient has a problem, acute or chronic, that will be treated with surgery, radiation, or some other type of generally time-limited intervention; reporting clinician service examples include but are not limited to, the orthopedic surgeon performing a knee replacement and seeing the patient through the postoperative period
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
Action
Notes
2008-01-01 Changed Code description changed.
1993-01-01 Added First appearance in code book in 1993.
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