Summary & Overview
CPT 27003: Open Adductor Tenotomy with Obturator Nerve Removal
CPT code 27003 describes an open tenotomy of the hip adductor muscle combined with removal of the obturator nerve. The procedure is a surgical intervention used in cases of refractory adductor tendon pathology or spasticity where tendon release and denervation are indicated. Nationally, surgical codes for lower-extremity tendon procedures and neurotomy influence inpatient and ambulatory surgical utilization, surgical resource planning, and coding compliance for orthopedic and neurosurgical services.
Key payers included in the analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a clinical and billing overview of the procedure, typical sites of service, and the context needed for accurate coding and claim submission. The publication also outlines common modifiers associated with surgical services and highlights considerations relevant to payer policies and coverage determinations.
This summary provides an accessible reference for coding professionals, billing staff, and clinicians involved in surgical care for hip adductor conditions. It clarifies the code’s clinical intent, situates the service within surgical care settings, and previews the operational and policy issues that affect reimbursement and utilization at a national level.
Billing Code Overview
CPT code 27003 describes an open tenotomy of the hip adductor muscle with removal of the obturator nerve. This surgical procedure involves division of the adductor tendon and excision of the obturator nerve to address persistent adductor-related pathology.
Service type: Surgical — Open tendon procedure with neurotomy
Typical site of service: Inpatient or outpatient surgical suite or ambulatory surgical center, depending on clinical complexity and facility capabilities.
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Clinical & Coding Specifications
Clinical Context
A 12-year-old child with spastic cerebral palsy presents with progressive scissoring gait and limited hip abduction due to tight adductor muscles and recurrent hip subluxation. Conservative management including physical therapy, botulinum toxin injections, and orthotic adjustments failed to improve function or pain. The multidisciplinary team (pediatric orthopedics, physical medicine and rehabilitation, anesthesia) evaluates the patient and recommends surgical release. During the scheduled procedure under general anesthesia in an outpatient surgical center or hospital operating room, the surgeon performs an open adductor tenotomy (surgical division of the adductor tendons) to decrease adductor spasticity and improve hip positioning. Intraoperatively, identification of dense scar tissue and persistent neurogenic pain prompts performance of an obturator nerve neurectomy (removal) to reduce spasm and pain. Postoperative workflow includes PACU recovery, short inpatient observation if needed for pediatric monitoring, pain control, early mobilization with physical therapy, and follow-up for wound checks and gait assessment. Typical sites of service are hospital inpatient, hospital outpatient department, or ambulatory surgical center depending on patient comorbidities and anesthesia requirements.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
52 | Reduced services | Use when the tenotomy or neurectomy is partially performed or substantially reduced in scope. |