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Official Description

Percutaneous skeletal fixation of tibial shaft fracture (with or without fibular fracture) (eg, pins or screws)

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

The procedure described by CPT® Code 27756 involves the percutaneous skeletal fixation of a tibial shaft fracture, which may also include a fracture of the fibula. This type of fracture is typically confirmed through radiological studies that are reported separately. During the procedure, if the fracture fragments are found to be displaced, they are manually manipulated back into their anatomical alignment. Following this manipulation, additional radiological studies are conducted to ensure that the fracture fragments have been successfully reduced to their proper positions. The technique involves making small incisions in the skin, through which pins or screws are inserted across the fracture site. These devices are crucial for maintaining the alignment of the fracture fragments during the healing process. After the fixation is completed, a cast or splint may be applied as necessary to provide further support and stabilization to the affected area. This procedure is distinct from other methods of fracture treatment, such as open treatment with plate and screw fixation or the use of intramedullary implants, which involve different surgical techniques and approaches to stabilize the fracture.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The procedure described by CPT® Code 27756 is indicated for the treatment of tibial shaft fractures, which may occur with or without associated fibular fractures. The primary indications for performing this procedure include:

  • Tibial Shaft Fracture A fracture occurring in the shaft of the tibia, which is the larger bone in the lower leg.
  • Fibular Fracture An associated fracture of the fibula, which is the smaller bone located alongside the tibia.
  • Displacement of Fracture Fragments When the fracture fragments are displaced, requiring manual manipulation to restore anatomical alignment.

2. Procedure

The procedure for CPT® Code 27756 involves several key steps to ensure proper fixation of the tibial shaft fracture:

  • Verification of Fracture Initially, the tibial shaft fracture is confirmed through radiological studies, which may include X-rays or other imaging techniques to assess the extent of the fracture and any displacement of fragments.
  • Manual Manipulation If the fracture fragments are displaced, the surgeon manually manipulates them back into their anatomical alignment. This step is critical to ensure proper healing and function of the limb.
  • Additional Radiological Studies After manipulation, further radiological studies are performed to verify that the fracture fragments have been successfully reduced and are in the correct position.
  • Incision and Fixation Small incisions are made in the skin over the fracture site. Through these incisions, pins or screws are inserted across the fracture site. These devices are essential for maintaining the alignment of the fracture fragments during the healing process.
  • Application of Cast or Splint Following the fixation, a cast or splint may be applied as needed to provide additional support and stabilization to the affected area, ensuring that the fracture remains properly aligned during recovery.

3. Post-Procedure

Post-procedure care for patients undergoing CPT® Code 27756 typically includes monitoring for signs of complications, such as infection or improper healing. Patients may be advised to keep the affected limb elevated and to follow specific weight-bearing restrictions as determined by the physician. Follow-up appointments are essential to assess the healing process through additional radiological studies and to make any necessary adjustments to the treatment plan. The duration of recovery may vary based on the severity of the fracture and the patient's overall health, but adherence to post-procedure instructions is crucial for optimal recovery.

Short Descr TREATMENT OF TIBIA FRACTURE
Medium Descr PRQ SKELETAL FIXATION TIBIAL SHAFT FRACTURE
Long Descr Percutaneous skeletal fixation of tibial shaft fracture (with or without fibular fracture) (eg, pins or screws)
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) P3D - Major procedure, orthopedic - other
MUE 1
CCS Clinical Classification 147 - Treatment, fracture or dislocation of lower extremity (other than hip or femur)
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).
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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