Summary & Overview
CPT 27065: Excision of Superficial Bone Cyst or Benign Tumor
CPT code 27065 designates surgical removal of a superficial bone cyst or benign tumor from the wing of the ilium, the symphysis pubis, or the greater trochanter of the femur, with optional reconstruction using the patient’s own bone graft. This code captures a focused orthopedic oncology or musculoskeletal surgery procedure commonly performed in hospital operating rooms and ambulatory surgical centers. Nationally, accurate coding for procedures like 27065 matters for appropriate clinical documentation, resource allocation, and consistent claims adjudication across payers.
Key payers discussed in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of the clinical context for the procedure, common places of service, typical billing considerations, and high-level benchmarking themes. The publication also summarizes common modifiers and service-line implications where available. Data not available in the input is identified as such, and no state-specific policy variances are addressed. The content is intended to help clinicians, coding professionals, and policy analysts understand what CPT code 27065 represents and what to expect in national payer interactions and administrative workflows.
Billing Code Overview
CPT code 27065 describes the surgical excision of a superficial bone cyst or benign tumor located in the wing of the ilium, the symphysis pubis, or the greater trochanter of the femur. The procedure may include reconstruction of the excised bone segment using an autologous bone graft harvested from the same patient.
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Service type: Surgical excision of benign bone lesion with possible autologous bone grafting
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Typical site of service: Hospital inpatient or outpatient surgical setting, or ambulatory surgical center
Clinical & Coding Specifications
Clinical Context
A 28-year-old male presents with progressive lateral hip pain and an enlarging, painful palpable mass over the greater trochanter. Imaging (radiograph and MRI) demonstrates a well-circumscribed, superficial benign bone tumor consistent with a simple bone cyst located in the lateral ilium/greater trochanter region without cortical breach or neurovascular compromise. After multidisciplinary discussion, the orthopedic oncology surgeon schedules an operative excision of the lesion with intraoperative pathology confirmation and planned autogenous cancellous bone grafting from the ipsilateral iliac crest to reconstruct the defect.
Preoperative workflow includes focused history and exam, cross-sectional imaging, surgical consent, anesthesia evaluation (general or regional), baseline labs, and perioperative antibiotics. Intraoperatively the surgeon excises the superficial cyst/tumor, sends specimens for frozen and permanent pathology, and obtains graft from the patient if needed. Postoperative care includes pain control, wound management, weight-bearing restrictions as indicated, and follow-up imaging to confirm graft incorporation and absence of recurrence.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when work or time substantially exceeds usual for 27065 (document rationale). |