Summary & Overview

CPT 20150: Epiphyseal (Physis) Bar Resection with Fat Interposition

CPT code 20150 represents surgical excision of an epiphyseal (physis) bar with autogenous fat interposition to address premature growth arrest of long bones caused by trauma, infection, or other injury. This procedure restores potential for longitudinal bone growth in pediatric and adolescent patients and is a specialized orthopedic operation with implications for long-term limb development and function. Nationally, accurate coding of this service is important for procedure tracking, quality measurement, and appropriate payment for a technically demanding reconstructive technique. Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context, typical sites of service, and the service type associated with 20150. The publication summarizes payer coverage patterns, common modifier usage, and benchmarks where available, and it highlights policy updates and coding guidance relevant to orthopedic surgeons and revenue cycle staff. The content aims to clarify billing terminology, support correct code selection, and provide practical context for claims preparation and compliance at a national level.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareCPT 20150epiphyseal barphysis bar resectionpediatric orthopedicsoperative procedurefat interpositionorthopedic surgeryambulatory surgeryhospital outpatient

Billing Code Overview

CPT code 20150 describes surgical excision of an epiphyseal (physis) bar with interposition of autogenous fat to restore longitudinal bone growth. The procedure is performed to remove a bony bridge between the epiphysis and metaphysis that causes premature growth arrest after fracture, injury, or infection.

Service type: Operative orthopedic procedure — epiphyseal bar resection with fat interposition

Typical site of service: Hospital operating room or ambulatory surgical center, commonly performed by pediatric or orthopedic surgeons on an inpatient or outpatient surgical basis depending on patient age, comorbidities, and complexity.

Clinical & Coding Specifications

Clinical Context

A 12-year-old patient presents to pediatric orthopedic surgery with progressive angular deformity and limb-length discrepancy of the distal femur following a distal femoral physeal fracture 18 months earlier. Serial radiographs and a CT scan demonstrate an epiphyseal bar (physeal bar) occupying the medial two-thirds of the distal femoral physis with early partial growth arrest and progressive varus deformity. Physical examination confirms a 2.5 cm limb-length discrepancy and mechanical axis deviation. The clinical workflow includes preoperative imaging (radiographs, CT to localize the bar), discussion of operative options with the family, preoperative clearance, operative excision of the epiphyseal bar with interpositional autogenous fat grafting under general anesthesia in an ambulatory surgery center or hospital operating room, intraoperative fluoroscopic localization, postoperative immobilization or bracing, and scheduled radiographic and clinical follow-up to monitor physis function and limb alignment. Typical site of service is an ambulatory surgery center or hospital operating room. The service type is a surgical orthopedic procedure (epiphyseal bar excision with fat graft interposition) performed by pediatric or general orthopedic surgeons experienced in physeal-preserving techniques.

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component	Use when only the surgeon’s professional component is billed separately from technical services provided by the facility or hospital.

Taxonomy Code	Specialty	Notes
207P00000X	Orthopaedic Surgery	Pediatric and general orthopedists commonly perform epiphyseal bar excision.
2080P0001X	Pediatrics	Pediatric specialists involved in perioperative care and assessment.
207K00000X	Orthopaedic Surgery of the Lower Extremity	Subspecialists focusing on lower-extremity physeal injuries perform these procedures.
2086S0105X	Physical Medicine & Rehabilitation	Physicians managing postoperative rehabilitation and gait restoration.
207LP2900X	Orthopaedic Surgery of the Upper Extremity	Included when physeal bars occur in upper extremity long bones, e.g., distal radius.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`M91.21`	Juvenile osteochondrosis of distal femoral epiphysis	Physeal injury leading to partial growth arrest and epiphyseal bar formation in the distal femur.
`S89.012A`	Other injury of lower leg, right lower leg, initial encounter	Represents a prior traumatic physeal injury that can result in a physeal bar; used when specific fracture history is documented.
`S89.011A`	Other injury of lower leg, left lower leg, initial encounter	Same as above for the left side; laterality specified.
`M84.37`	Pathological fracture, other sites, multiple sites (use with site-specific extension)	Indicates weakened bone or prior infection leading to growth disturbance; relevant when bar results from infection or pathology.
`M21.6X1`	Other acquired deformities of limb, right lower limb	Used to report acquired angular deformity or limb-length discrepancy secondary to physeal arrest.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`11010`	Excision or curettage, benign lesion, soft tissue of trunk, arms or legs; simple	Occasionally billed if additional soft-tissue work or graft harvest site excision is separately reportable.
`20150`	Excision of epiphyseal (physeal) bar and implantation of autogenous fat graft	Primary procedure for removal of a physeal bar to restore growth potential.
`20680`	Removal of implant; deep (e.g., buried wires, pins, plates, screws)	Performed if prior hardware crossing the physis must be removed prior to bar excision.
`73562`	Radiologic examination, tibia and fibula, complete, minimum 3 views	Preoperative and postoperative radiographs to document deformity and monitor growth.
`76000`	Fluoroscopy (separate procedure), imaging guidance during surgical procedure	Intraoperative fluoroscopic localization of the physeal bar during excision.
`27096`	Osteotomy, femur or tibia, for correction of angular deformity, with internal fixation	May be performed in staged or combined procedures when deformity correction beyond bar excision is required.