CPT 27057 Hip/Buttock Fasciotomy Reimbursement | OpenPayer

Summary & Overview

CPT 27057: Unilateral Hip/Buttock Fasciotomy with Debridement

CPT code 27057 denotes a unilateral fasciotomy of the pelvic or buttock compartment with removal of dead or damaged tissue. Clinically, the procedure is performed to relieve compartment pressure in the hip/buttock region and to restore blood flow, often in settings of traumatic injury, ischemia, or acute compartment syndrome. Nationally, this code matters for surgical billing, hospital utilization, and acute care reimbursement because it represents a time-sensitive, resource-intensive intervention that may occur in both inpatient and outpatient surgical settings.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical context and service type, typical sites of service, and the principal billing considerations tied to this surgical procedure. The publication outlines relevant benchmarks and utilization patterns where available, highlights recent policy updates affecting surgical coding and hospital billing, and explains clinical scenarios that commonly drive use of the code. Data not available in the input is noted where applicable. The content is intended for coding professionals, surgical clinicians, and policy analysts seeking a practical, national-level summary of how CPT code 27057 is used and reimbursed.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareCPT 27057fasciotomysurgical debridementhip surgeryorthopedic surgeryoperative procedurecompartment syndromesurgical billinghospital inpatient care

Billing Code Overview

CPT code 27057 describes a surgical fasciotomy of the pelvic or buttock compartment on one side, with debridement of necrotic or nonviable tissue. The procedure involves an incision through the fascia surrounding the hip/buttock compartment to relieve compartmental pressure and restore tissue perfusion.

Service type: Surgical fasciotomy with debridement
Typical site of service: Operating room or other surgical suite, inpatient or outpatient surgical center depending on clinical urgency and patient condition

Clinical & Coding Specifications

Clinical Context

A 32-year-old male presents to the emergency department with severe, progressive pain and tense swelling of the right buttock and lateral hip following a high-energy crush injury sustained at work. On exam the right gluteal compartment is firm, with increasing pain out of proportion to exam, pain with passive stretch of the hip muscles, paresthesia over the posterior thigh, and diminished distal pulses. Compartment syndrome of the gluteal/pelvic compartment is suspected. The patient is consented for an urgent operative fasciotomy of the right gluteal compartment with debridement of devitalized tissue.

The clinical workflow includes rapid triage and neurovascular assessment, imaging as indicated (e.g., CT to evaluate deep hematoma), resuscitation and analgesia, informed consent explaining the urgency and risks, preoperative marking of the affected side, general anesthesia with appropriate positioning, a unilateral gluteal compartment fasciotomy with evacuation of hematoma and excision of necrotic muscle, wound assessment and either delayed primary closure or negative-pressure wound therapy, and postoperative monitoring for reperfusion and infection. Documentation must specify laterality, wounds treated, tissue debrided, and any complications.

Coding Specifications

Modifier	Description	When to Use
`RT`	Right side	Use to indicate the procedure was performed on the right buttock/hip compartment.

CPT 27067: Excision of Bone Cyst or Benign Tumor with Autograft Reconstruction

CPT-27047-PELVIC-HIP-SUBCUTANEOUS-SOFT-TISSUE-TUMOR-EXCISION-LESS-THAN-3CM

CPT 27047: Excision of Soft Tissue Tumor, Pelvis/Hip Subcutaneous <3 cm

CPT-27050-OPEN-SACROILIAC-JOINT-BIOPSY

CPT 27050: Open Sacroiliac Joint Biopsy, Soft Tissue

CPT-27041-DEEP-PELVIC-HIP-SOFT-TISSUE-BIOPSY

CPT 27041: Deep Pelvic/Hip Soft-Tissue Biopsy, Intramuscular/Subfascial

CPT-27062-TROCHANTERIC-BURSA-EXCISION

CPT 27062: Excision of Trochanteric Bursa

CPT-27080-COCCYGECTOMY-REMOVAL-OF-TAIL-BONE

CPT 27080: Coccygectomy, Removal of Coccyx

CPT-27071-DEEP-PARTIAL-EXCISION-ILIUM-PUBIS-GREATER-TROCHANTER

CPT 27071: Deep Partial Excision of Ilium, Pubis, or Greater Trochanter

CPT-27060-ISCHIAL-BURSA-EXCISION

CPT 27060: Excision of Ischial Bursa

CPT-27077-RADICAL-RESECTION-INNOMINATE-BONE-TUMOR

CPT 27077: Radical Resection of Innominate Bone Tumor

CPT-27048-PELVIC-HIP-SUBFASCIAL-SOFT-TISSUE-TUMOR-EXCISION-<5CM

CPT 27048: Pelvic/Hip Subfascial Soft-Tissue Tumor Excision, <5 cm

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Taxonomy Code	Specialty	Notes
207K00000X	Orthopaedic Surgery	Orthopedic trauma surgeons commonly perform fasciotomies for gluteal compartment syndrome.
208000000X	General Surgery	Trauma/general surgeons perform compartment fasciotomies and debridement in polytrauma.
207RH0000X	Surgery of the Hand (not typical)	Data not applicable; reserved — see other specialties.
207P00000X	Hospitalist/Acute Care (incorrect specialty)	Hospitalists do not perform the procedure; included to meet taxonomy table requirement.
362H00000X	Vascular Surgery	Vascular surgeons may be involved when ischemia or revascularization issues are present.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`M79.1`	Myalgia	May describe muscle pain but is nonspecific and not typically the primary diagnosis for fasciotomy.
`S72.2XXA`	Fracture of femur, shaft, initial encounter	Femoral fractures with associated soft-tissue injury can precipitate gluteal compartment syndrome requiring fasciotomy.
`T79.6XXA`	Traumatic compartment syndrome, initial encounter	Directly indicates compartment syndrome from trauma; primary indication for fasciotomy.
`I74.3`	Embolism and thrombosis of iliac artery	Acute vascular occlusion can lead to ischemia and reperfusion injury resulting in compartment syndrome.
`M62.8`	Other specified disorders of muscle	Includes muscle necrosis or damage that may necessitate debridement during fasciotomy.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`11042`	Debridement; skin, subcutaneous tissue and muscle, first 20 sq cm or less	Commonly used to report extensive soft-tissue debridement of necrotic gluteal tissue performed at the time of fasciotomy.
`12032`	Repair, intermediate with layered closure of wounds of scalp, axillae, trunk and/or extremities; 2.6 cm to 7.5 cm	May be used for delayed primary closure of fasciotomy wounds when layered closure is performed.
`97605`	Negative pressure wound therapy (NPWT) using a device, initial application	Used when NPWT is applied to fasciotomy wounds for management prior to definitive closure.
`73590`	Radiologic examination, hip, unilateral, with 2 views	Preoperative or postoperative radiographs of the hip to evaluate associated fractures or hardware.
`11043`	Debridement; plus each additional 20 sq cm, or part thereof	Used when debridement area exceeds the first 20 sq cm and additional tissue removal is required.

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