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Official Description

Osteotomy; fibula

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

An osteotomy of the fibula, as described by CPT® Code 27707, is a surgical procedure aimed at correcting deformities or realigning the fibula, which is one of the two long bones in the lower leg. This procedure may involve the fibular shaft or the distal end of the fibula, depending on the specific deformity being addressed. The term 'osteotomy' refers to the surgical cutting of bone, and in this context, it is performed to restore proper alignment and function of the fibula. Various techniques can be employed during the osteotomy, including transverse, wedge, sliding, right or left angle, V-osteotomy, and Z-osteotomy, each chosen based on the nature and location of the deformity. Prior to the surgery, the physician utilizes radiographic studies to precisely determine the locations for the bone cuts, ensuring that the procedure is tailored to achieve optimal results. The surgical approach involves making an incision over the lower leg, followed by careful dissection of the soft tissues to expose the fibula. The periosteum, a dense layer of connective tissue surrounding the bone, is elevated to facilitate access. The actual osteotomy is performed using specialized instruments such as drills, saws, or osteotomes to create the necessary bone cuts. In some cases, bone grafts may be inserted between the cut segments to promote healing and stability. To maintain the correct alignment of the bone after the osteotomy, various fixation methods, including pins, screws, or plates, may be employed. Alternatively, an external fixation device can be used if deemed appropriate. This procedure is critical for patients with fibular deformities, as it aims to restore normal anatomy and function, ultimately improving mobility and quality of life.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The osteotomy of the fibula, coded as CPT® 27707, is indicated for various conditions that necessitate correction of fibular deformities. These indications may include:

  • Deformity Correction - The procedure is performed to correct congenital or acquired deformities of the fibula that may affect limb function.
  • Realignment of Bone - It is indicated for cases where the fibula is misaligned due to trauma, disease, or other factors that compromise the structural integrity of the bone.
  • Improvement of Function - The surgery aims to enhance the overall function of the lower limb, particularly in patients experiencing pain or mobility issues related to fibular deformities.

2. Procedure

The procedure for performing an osteotomy of the fibula involves several critical steps, which are outlined as follows:

  • Step 1: Preoperative Planning - Prior to the surgical intervention, the physician conducts radiographic studies to identify the precise location and configuration of the osteotomy required to correct the deformity. This planning is essential to ensure that the surgical approach is tailored to the specific needs of the patient.
  • Step 2: Incision and Exposure - An incision is made over the lower leg to access the fibula. The surgeon carefully dissects the soft tissues to expose the fibula and elevate the periosteum, which is the protective layer surrounding the bone, to facilitate the osteotomy.
  • Step 3: Bone Cutting - Using a drill, saw, or osteotome, the surgeon performs the osteotomy by cutting the fibula in the predetermined configuration. The type of cut may vary based on the specific deformity being addressed, and the surgeon ensures that the cuts are made accurately to achieve the desired alignment.
  • Step 4: Bone Grafting (if necessary) - In cases where additional support is needed, bone grafts may be interposed between the cut segments of the fibula to promote healing and stability.
  • Step 5: Internal or External Fixation - After the osteotomy is completed, the surgeon applies fixation devices, which may include pins, screws, or plates, to secure the cut edges of the fibula in anatomical alignment. Alternatively, an external fixation device may be utilized if appropriate for the patient's condition.

3. Post-Procedure

Following the osteotomy of the fibula, patients typically require a period of recovery that may involve immobilization of the leg to allow for proper healing. The physician will provide specific post-operative care instructions, which may include pain management, physical therapy, and follow-up appointments to monitor the healing process. Patients are advised to avoid weight-bearing activities on the affected leg until cleared by their healthcare provider. The expected recovery time can vary based on the individual patient's condition and the complexity of the procedure, but adherence to post-operative guidelines is crucial for optimal outcomes.

Short Descr OSTEOTOMY FIBULA
Medium Descr OSTEOTOMY FIBULA
Long Descr Osteotomy; fibula
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) 1 - Statutory payment restriction for assistants at surgery applies 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 Surgical procedure on ASC list in CY 2007; payment based on OPPS relative payment weight.
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) P3D - Major procedure, orthopedic - other
MUE 1
CCS Clinical Classification 161 - Other OR therapeutic procedures on bone
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.
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).
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).
AQ Physician providing a service in an unlisted health professional shortage area (hpsa)
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
Date
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2025-01-01 Changed Short Description changed.
Pre-1990 Added Code added.
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