CPT 0547T: Tibial Reference Point Indentation for Bone Quality Assessment

CPT code 0547T represents an invasive diagnostic procedure that inserts a reference point indenter into the tibial shaft to measure bone stiffness and toughness, producing a quantitative score. This measurement can inform preoperative planning for joint replacement and help assess fracture risk in patients with osteoporosis or osteopenia. Nationally, the code is relevant as interest grows in objective bone quality metrics to complement imaging and bone mineral density tests.

Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The analysis covers coverage and billing considerations across major commercial payers and Medicare, identifying where policy updates or coding guidance may affect clinical adoption and reimbursement workflows.

Readers will find a concise briefing on the clinical purpose and typical settings for the service, common billing modifiers, and where to look for supporting documentation. The publication also outlines benchmarks and policy themes relevant to payers and providers, and highlights practical coding and documentation points to consider when reporting CPT code 0547T for bone quality assessment in joint replacement planning and fracture-risk evaluation.

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Billing Code Overview

CPT code 0547T describes the insertion of a reference point indenter through the skin into the shaft of the tibia to assess bone stiffness and toughness. Results are reported as a score that may provide bone quality information useful for planning joint replacement surgery and evaluating fracture risk in patients with osteoporosis or osteopenia.

Service type: Diagnostic bone quality assessment using invasive reference point indentation

Typical site of service: Ambulatory surgical center or hospital outpatient department

Data not available in the input.

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CPT 0547T: Tibial Reference Point Indentation for Bone Quality Assessment

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Billing Code Overview

Service type: Diagnostic bone quality assessment using invasive reference point indentation

Typical site of service: Ambulatory surgical center or hospital outpatient department

Data not available in the input.

Clinical & Coding Specifications

Clinical Context

A 72-year-old woman with a history of osteoporosis is scheduled for primary total hip arthroplasty. Preoperative assessment raises concern about bone quality and risk of intraoperative fracture and implant subsidence. The orthopedic surgeon elects to perform a transcutaneous tibial reference point indenter test immediately prior to surgery in the preoperative holding area or in the operating room under the same anesthetic. The procedure involves insertion of a small reference point indenter through the skin into the tibial shaft to measure bone stiffness and toughness; the device yields a numeric score that informs intraoperative decisions such as implant selection, fixation method (cemented versus cementless), and need for adjunctive fixation.

Typical clinical workflow:

Patient arrives to preoperative area with informed consent completed for the primary joint replacement and ancillary bone-quality testing.
Pre-anesthesia verification and positioning for the test; local anesthesia or monitored anesthesia care may be used if performed awake, or the test may be performed after induction if done in the OR.
Skin antisepsis and sterile draping of the proximal tibia.
Provider identifies a reference point on the tibial shaft, inserts the indenter per device instructions, and records the quantitative bone quality score.
Results are documented in the operative or preoperative record and used to guide implant selection and fixation strategy during the joint replacement procedure.
Routine postprocedure dressing and monitoring for bleeding, infection, or pain; documentation of device score and any immediate complications.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	When work required is substantially greater than typical for the procedure (e.g., extensive time or complexity during indenter placement due to severe deformity).
`23`	Unusual anesthesia	When general anesthesia is administered for an otherwise normally non-anesthetized procedure.
`51`	Multiple procedures	When the indenter test is reported on the same day as other distinct procedures and multiple-procedure reporting rules apply.
`52`	Reduced services	When the indenter test is partially reduced or not completed as planned.
`53`	Discontinued procedure	When the test is started but stopped due to patient instability or unsafe conditions.
`54`	Surgical care only	When the reporting provider renders only the surgical portion of care and another provider reports pre/postoperative care.
`55`	Postoperative management only	When the reporting provider furnishes only postoperative management related to the test or subsequent surgery.
`62`	Two surgeons	When two surgeons of different specialties share the procedure, both contributing distinct skills for indenter placement or interpretation.
`73`	Discontinued outpatient procedure prior to anesthesia	When the test is canceled after patient preparation but before regional or general anesthesia and reported per payer rules.
`AS`	Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery	When an accredited assistant performs assisting tasks during placement in accordance with state law.

Taxonomy Code	Specialty	Notes
`207X00000X`	Orthopaedic Surgery	Primary specialty performing joint replacement and intraoperative bone quality assessment.
`207L00000X`	Hand Surgery (Orthopedic subspecialty)	Orthopedic subspecialists who may perform musculoskeletal diagnostic interventions; less common for tibial indenter testing.
`208000000X`	Physical Medicine & Rehabilitation	May be involved in preoperative functional assessment and bone-health optimization discussions.
`2086S0105X`	Osteoporosis Specialist (Endocrinology-related)	Specialists managing metabolic bone disease who may order or interpret bone quality testing.
`208000000X`	Anesthesiology	Provides sedation or monitored anesthesia care if the procedure is performed under anesthesia.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`M80.00XA`	Age-related osteoporosis with current pathological fracture, unspecified site, initial encounter	Osteoporosis with fracture risk directly relates to need for bone-quality assessment to guide fixation and implant choice.
`M81.0`	Age-related osteoporosis without current pathological fracture	Common indication for bone-quality testing to assess fracture risk and plan surgical approach.
`M84.461A`	Stress fracture, tibia, right leg, initial encounter	Local tibial pathology may affect measurement validity or site selection for indenter testing.
`M84.462A`	Stress fracture, tibia, left leg, initial encounter	As above for the contralateral tibia.
`M19.90`	Osteoarthritis, unspecified site	Underlying joint degeneration prompting arthroplasty where bone quality assessment is useful.
`Z79.51`	Long term (current) use of bisphosphonates	Medication history relevant to bone quality interpretation and fracture risk assessment.
`Z87.310`	Personal history of (healed) osteoporosis fracture	Prior fracture history increases relevance of intraoperative bone-strength assessment.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`0547T`	Insertion of reference point indenter into tibial shaft to assess bone stiffness/toughness; results reported as a score	Primary procedure described.
`27130`	Arthroplasty, acetabular and proximal femoral prosthetic implantation (total hip arthroplasty)	Common definitive surgery for which tibial indenter testing may inform implant selection and fixation technique.
`27447`	Arthroplasty, knee, condyle and plateau; medial and lateral compartments with or without patellar resurfacing (total knee arthroplasty)	Another joint replacement where preoperative or intraoperative bone quality assessment may guide fixation decisions.
`77080`	Dual-energy X-ray absorptiometry (DXA) bone density study, 1 or more sites; axial skeleton	Preoperative bone density testing often performed to evaluate osteoporosis risk and complement intraoperative indenter results.
`20690`	Arthrocentesis, aspiration and/or injection; major joint or bursa (e.g., knee, subacromial bursa)	Performed in the perioperative workup or to treat inflammatory conditions that may coexist with joint degeneration and influence surgical planning.

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

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Clinical & Coding Specifications

Clinical Context

Typical clinical workflow:

Patient arrives to preoperative area with informed consent completed for the primary joint replacement and ancillary bone-quality testing.
Pre-anesthesia verification and positioning for the test; local anesthesia or monitored anesthesia care may be used if performed awake, or the test may be performed after induction if done in the OR.
Skin antisepsis and sterile draping of the proximal tibia.
Provider identifies a reference point on the tibial shaft, inserts the indenter per device instructions, and records the quantitative bone quality score.
Results are documented in the operative or preoperative record and used to guide implant selection and fixation strategy during the joint replacement procedure.
Routine postprocedure dressing and monitoring for bleeding, infection, or pain; documentation of device score and any immediate complications.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	When work required is substantially greater than typical for the procedure (e.g., extensive time or complexity during indenter placement due to severe deformity).
`23`	Unusual anesthesia	When general anesthesia is administered for an otherwise normally non-anesthetized procedure.
`51`	Multiple procedures	When the indenter test is reported on the same day as other distinct procedures and multiple-procedure reporting rules apply.
`52`	Reduced services	When the indenter test is partially reduced or not completed as planned.
`53`	Discontinued procedure	When the test is started but stopped due to patient instability or unsafe conditions.
`54`	Surgical care only	When the reporting provider renders only the surgical portion of care and another provider reports pre/postoperative care.
`55`	Postoperative management only	When the reporting provider furnishes only postoperative management related to the test or subsequent surgery.
`62`	Two surgeons	When two surgeons of different specialties share the procedure, both contributing distinct skills for indenter placement or interpretation.
`73`	Discontinued outpatient procedure prior to anesthesia	When the test is canceled after patient preparation but before regional or general anesthesia and reported per payer rules.
`AS`	Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery	When an accredited assistant performs assisting tasks during placement in accordance with state law.

Taxonomy Code	Specialty	Notes
`207X00000X`	Orthopaedic Surgery	Primary specialty performing joint replacement and intraoperative bone quality assessment.
`207L00000X`	Hand Surgery (Orthopedic subspecialty)	Orthopedic subspecialists who may perform musculoskeletal diagnostic interventions; less common for tibial indenter testing.
`208000000X`	Physical Medicine & Rehabilitation	May be involved in preoperative functional assessment and bone-health optimization discussions.
`2086S0105X`	Osteoporosis Specialist (Endocrinology-related)	Specialists managing metabolic bone disease who may order or interpret bone quality testing.
`208000000X`	Anesthesiology	Provides sedation or monitored anesthesia care if the procedure is performed under anesthesia.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`M80.00XA`	Age-related osteoporosis with current pathological fracture, unspecified site, initial encounter	Osteoporosis with fracture risk directly relates to need for bone-quality assessment to guide fixation and implant choice.
`M81.0`	Age-related osteoporosis without current pathological fracture	Common indication for bone-quality testing to assess fracture risk and plan surgical approach.
`M84.461A`	Stress fracture, tibia, right leg, initial encounter	Local tibial pathology may affect measurement validity or site selection for indenter testing.
`M84.462A`	Stress fracture, tibia, left leg, initial encounter	As above for the contralateral tibia.
`M19.90`	Osteoarthritis, unspecified site	Underlying joint degeneration prompting arthroplasty where bone quality assessment is useful.
`Z79.51`	Long term (current) use of bisphosphonates	Medication history relevant to bone quality interpretation and fracture risk assessment.
`Z87.310`	Personal history of (healed) osteoporosis fracture	Prior fracture history increases relevance of intraoperative bone-strength assessment.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`0547T`	Insertion of reference point indenter into tibial shaft to assess bone stiffness/toughness; results reported as a score	Primary procedure described.
`27130`	Arthroplasty, acetabular and proximal femoral prosthetic implantation (total hip arthroplasty)	Common definitive surgery for which tibial indenter testing may inform implant selection and fixation technique.
`27447`	Arthroplasty, knee, condyle and plateau; medial and lateral compartments with or without patellar resurfacing (total knee arthroplasty)	Another joint replacement where preoperative or intraoperative bone quality assessment may guide fixation decisions.
`77080`	Dual-energy X-ray absorptiometry (DXA) bone density study, 1 or more sites; axial skeleton	Preoperative bone density testing often performed to evaluate osteoporosis risk and complement intraoperative indenter results.
`20690`	Arthrocentesis, aspiration and/or injection; major joint or bursa (e.g., knee, subacromial bursa)	Performed in the perioperative workup or to treat inflammatory conditions that may coexist with joint degeneration and influence surgical planning.

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

CPT 0547T: Tibial Reference Point Indentation for Bone Quality Assessment

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Billing Code Overview

CPT 0547T: Tibial Reference Point Indentation for Bone Quality Assessment

Sign up for cpt 0547T policy alerts

Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

What does CPT 0547T describe and where is it typically performed?

Which other CPT codes are commonly associated with the tibial indenter test?

What modifiers are relevant when billing CPT 0547T?

In what clinical situations and workflow is the tibial reference point indenter test used?

Which payers are discussed for coverage and reimbursement considerations for CPT 0547T?

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

What does CPT 0547T describe and where is it typically performed?

Which other CPT codes are commonly associated with the tibial indenter test?

What modifiers are relevant when billing CPT 0547T?

In what clinical situations and workflow is the tibial reference point indenter test used?

Which payers are discussed for coverage and reimbursement considerations for CPT 0547T?

References