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Official Description

Open treatment of proximal fibula or shaft fracture, includes internal fixation, when performed

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

The procedure described by CPT® Code 27784 pertains to the open treatment of fractures located in the proximal fibula or the shaft of the fibula, which is one of the two long bones in the lower leg. The fibula is situated on the lateral side of the leg and is smaller than the tibia, the larger bone that supports most of the weight. The proximal fibula is the upper part of the fibula that connects with the tibia, while the shaft refers to the elongated middle section of the bone. This surgical intervention involves making a longitudinal incision over the fracture site, which can be either at the proximal fibula or along the shaft. During the procedure, careful dissection through the surrounding soft tissue is performed to expose the fracture while protecting the peroneal nerve, which runs close to the fibula. Once the fracture is adequately exposed and any debris is cleared, the fracture is reduced, meaning the bone fragments are realigned to their normal position. If necessary, internal fixation is applied using devices such as plates and screws to stabilize the fracture. After the fixation, the surgical site is irrigated to prevent infection, and the incision is then closed. This procedure is critical for restoring the structural integrity of the fibula and ensuring proper healing and function of the lower leg.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The open treatment of proximal fibula or shaft fractures, as described by CPT® Code 27784, is indicated for specific conditions and symptoms that necessitate surgical intervention. These indications include:

  • Proximal Fibula Fracture - A fracture occurring at the upper part of the fibula, which may result from trauma or injury.
  • Shaft Fracture - A fracture located in the middle section of the fibula, often due to direct impact or torsional forces.
  • Displaced Fracture - Fractures where the bone fragments are not aligned properly, requiring surgical realignment for proper healing.
  • Fractures Associated with Ligament Injuries - Instances where fibula fractures occur alongside injuries to surrounding ligaments, necessitating stabilization.

2. Procedure

The procedure for the open treatment of proximal fibula or shaft fractures involves several critical steps to ensure proper alignment and stabilization of the fractured bone. The steps include:

  • Step 1: Incision - A longitudinal incision is made over the fracture site, which can be located at the proximal fibula or along the shaft of the fibula. This incision allows access to the underlying bone and soft tissues.
  • Step 2: Dissection - The surgeon carefully dissects through the soft tissue layers to expose the fracture site. During this process, special attention is given to isolate and protect the peroneal nerve, which is crucial to prevent nerve damage.
  • Step 3: Exposure and Clearance - Once the fracture site is adequately exposed, any debris or hematoma present at the fracture site is cleared away to facilitate a clean working area for the repair.
  • Step 4: Reduction - The fracture is then reduced, meaning the bone fragments are realigned to their anatomical position. This step is essential for ensuring proper healing and function of the fibula.
  • Step 5: Internal Fixation - If deemed necessary, internal fixation devices such as plates and screws are applied to stabilize the fracture. This fixation helps maintain the alignment of the bone during the healing process.
  • Step 6: Wound Irrigation and Closure - After the fixation is completed, the surgical site is thoroughly irrigated to reduce the risk of infection. Finally, the incision is closed using appropriate suturing techniques.

3. Post-Procedure

Post-procedure care following the open treatment of proximal fibula or shaft fractures is crucial for optimal recovery. Patients are typically monitored for any signs of complications, such as infection or improper healing. Pain management strategies are implemented to ensure patient comfort. Rehabilitation may be initiated to restore mobility and strength, often involving physical therapy. The duration of recovery can vary based on the severity of the fracture and the patient's overall health, but follow-up appointments are essential to assess healing progress and to determine when weight-bearing activities can safely resume.

Short Descr TREATMENT OF FIBULA FRACTURE
Medium Descr OPEN TREATMENT PROXIMAL FIBULA/SHAFT FRACTURE
Long Descr Open treatment of proximal fibula or shaft fracture, 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) 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) P5B - Ambulatory procedures - musculoskeletal
MUE 1
CCS Clinical Classification 147 - Treatment, fracture or dislocation of lower extremity (other than hip or femur)
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).
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.)
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)
SG Ambulatory surgical center (asc) facility service
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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2008-01-01 Changed Code description changed.
Pre-1990 Added Code added.
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