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Official Description

Osteoplasty, tibia and fibula, lengthening or shortening

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

The procedure described by CPT® Code 27715 involves osteoplasty of the tibia and fibula, which refers to a surgical intervention aimed at either lengthening or shortening these long bones in the lower leg. Osteoplasty is a type of plastic surgery that modifies the structure of bones to achieve specific functional or aesthetic outcomes. In this procedure, the physician utilizes imaging studies to precisely determine the locations for bone cuts before initiating the surgery. This preoperative planning is crucial for ensuring that the desired lengthening or shortening of the bones is achieved effectively. During the operation, the tibia and fibula are surgically exposed, allowing the surgeon to access the bone directly. For shortening, the surgeon identifies the appropriate sites for cutting, excises segments of the bone, and then brings the remaining ends together, stabilizing them with internal fixation methods. Conversely, for lengthening, the bones are cut and gradually distracted, and a bone graft may be harvested from the iliac crest to fill any defects created during the procedure. This complex surgical intervention requires careful execution and is typically performed in a controlled clinical environment to ensure patient safety and optimal outcomes.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The procedure is indicated for various conditions that necessitate the alteration of the length of the tibia and fibula. These may include:

  • Bone Deformities Conditions where the tibia or fibula is abnormally shaped or positioned, requiring correction to restore normal function and alignment.
  • Leg Length Discrepancy Situations where one leg is shorter than the other, which can lead to gait abnormalities and discomfort.
  • Post-Traumatic Reconstruction Cases where previous fractures or injuries have resulted in improper healing or malalignment of the bones.
  • Congenital Anomalies Birth defects affecting the growth and development of the tibia and fibula that may require surgical intervention to improve mobility and function.

2. Procedure

The procedure consists of several critical steps that ensure the successful lengthening or shortening of the tibia and fibula. These steps include:

  • Preoperative Planning Prior to the surgical intervention, the physician conducts radiographic studies to determine the precise locations for the bone cuts. This imaging is essential for planning the surgical approach and ensuring optimal outcomes.
  • Exposure of the Tibia and Fibula The surgeon makes an incision to expose the tibia and fibula, providing direct access to the bones for the surgical procedure.
  • Shortening Procedure For cases requiring shortening, the surgeon identifies the sites for bone cuts, excises the necessary segments of the tibia and fibula, and brings the remaining ends into contact. Internal fixation is then applied to stabilize the reconfigured bones, ensuring they remain in the correct position during the healing process.
  • Lengthening Procedure In cases where lengthening is required, the surgeon makes cuts in both the tibia and fibula and applies distraction techniques to gradually separate the bone segments. A bone autograft is harvested from the iliac crest, where a skin incision is made, and muscle is stripped to expose the bone surface. The surgeon then harvests cortical and/or cancellous bone, which is shaped and packed into any defects created during the procedure. Internal fixation devices, such as pins, screws, or plates, are used to secure the bone edges in anatomical alignment, or alternatively, an external fixation device may be applied.

3. Post-Procedure

After the procedure, patients typically require careful monitoring and follow-up care to ensure proper healing and alignment of the bones. Post-operative care may include pain management, physical therapy to restore mobility, and regular imaging studies to assess the healing process. Patients are advised on activity restrictions to prevent complications and ensure optimal recovery. The duration of recovery can vary based on the complexity of the procedure and the individual patient's healing response.

Short Descr OSTPL TIBFIB LNGTH/SHRT
Medium Descr OSTEOPLASTY TIBIA&FIBULA LENGTHENING/SHORTENING
Long Descr Osteoplasty, tibia and fibula, lengthening or shortening
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 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 161 - Other OR therapeutic procedures on bone
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).
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.
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.)
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).
AS Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery
CR Catastrophe/disaster related
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)
Date
Action
Notes
2025-01-01 Changed Short and Medium Descriptions changed.
2013-01-01 Changed Medium Descriptor changed.
Pre-1990 Added Code added.
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