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The CPT® Code 27637 refers to the procedure involving the excision or curettage of a bone cyst or benign tumor located in the tibia or fibula, accompanied by the use of an autograft. 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 the most common, characterized as a benign lesion. In contrast, the aneurysmal bone cyst is less common and is composed of vascular tissue surrounding a blood-filled cystic lesion. Additionally, there are various benign bone tumors, including giant cell tumors, chondromyxoid fibromas, and enchondromas. The procedure begins with an incision made over the lesion site in the tibia or fibula, followed by dissection of the soft tissues to expose the lesion. If a cystic lesion is identified, the bone is incised to create a window, allowing for the aspiration of fluid, which is then sent for laboratory analysis. The lining of the cystic cavity is removed through curettage, or the benign tumor may be excised along with a margin of healthy bone. Following the removal of the lesion, the procedure involves obtaining healthy bone, either from the same site or from a donor site such as the iliac crest, which is then packed into the defect created in the tibia or fibula. This comprehensive approach ensures the effective treatment of the bone cyst or benign tumor while promoting healing through the use of the autograft.
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The procedure described by CPT® Code 27637 is indicated for the treatment of specific conditions related to bone cysts and benign tumors in the tibia or fibula. The following are the primary indications for performing this procedure:
The procedure for CPT® Code 27637 involves several critical steps to ensure the effective treatment of the bone cyst or benign tumor:
Post-procedure care following the excision or curettage of a bone cyst or benign tumor includes monitoring for any signs of infection, managing pain, and ensuring proper healing of the surgical site. Patients may be advised to limit weight-bearing activities on the affected limb for a specified period to facilitate recovery. Follow-up appointments are essential to assess the healing process and to ensure that the graft is integrating properly with the surrounding bone. Additional imaging studies may be required to evaluate the success of the procedure and to monitor for any recurrence of the cyst or tumor.
| Short Descr | REMOVE/GRAFT LEG BONE LESION | Medium Descr | EXC/CURETTAGE CYST/TUMOR TIBIA/FIBULA W/AGRAFT | Long Descr | Excision or curettage of bone cyst or benign tumor, tibia or fibula; 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) | P5B - Ambulatory procedures - musculoskeletal | MUE | 1 | CCS Clinical Classification | 142 - Partial excision bone |
| 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 | 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. | 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. | 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. | 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 | 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 | 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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