Summary & Overview
CPT 27077: Radical Resection of Innominate Bone Tumor
CPT code 27077 represents a radical resection of a tumor of the innominate bone, a major pelvic oncologic procedure that removes the tumor plus surrounding healthy tissue to achieve clear margins. This code captures a high-complexity musculoskeletal oncology service with implications for surgical planning, post-operative care, and facility utilization. Nationally, accurate coding of complex pelvic tumor resections affects resource allocation, case mix reporting, and payments across public and commercial payers.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication provides clinicians, coders, and policy teams with a concise reference on clinical context, expected service setting, and how this procedure is classified for billing purposes.
Readers will learn: the clinical scope and operative intent of CPT code 27077; typical sites of service and service type for this procedure; payer coverage landscape and common modifier practices where data are available; and where input data are incomplete. The summary highlights benchmarks and policy-relevant considerations for institutions that perform complex pelvic tumor resections and for payers reviewing high-acuity surgical claims. Data not available in the input are noted where applicable.
Billing Code Overview
CPT code 27077 describes a radical resection of a tumor of the innominate bone, a surgical oncologic procedure in which the provider excises a pelvic tumor along with a margin of healthy tissue on either side to achieve oncologic control. The innominate bone refers to either of the two large pelvic bones formed by the fusion of the ilium, ischium, and pubis.
Service type: Surgical oncology / orthopedic oncologic resection
Typical site of service: Inpatient or outpatient surgical setting depending on case complexity, commonly an operating room at a hospital or ambulatory surgical center.
Clinical & Coding Specifications
Clinical Context
A 48-year-old patient presents with progressive pelvic pain, pelvic mass on imaging, and biopsy-confirmed primary malignant bone tumor arising from the innominate bone. Imaging (pelvic MRI and CT) demonstrates a localized lesion involving the iliac wing with cortical destruction and soft-tissue extension but without distant metastases. The multidisciplinary care team (orthopedic oncology surgeon, medical oncology, radiation oncology, radiology, and anesthesiology) plans a 27077 radical resection of the innominate bone to achieve oncologic margins.
Preoperative workflow includes staging studies, multidisciplinary tumor board review, informed consent describing risks (bleeding, infection, neurovascular injury, pelvic instability), pre-op labs and cross-match, and anesthesia evaluation. Intraoperative care involves oncologic exposure of the pelvis, wide excision of the tumor plus several centimeters of surrounding healthy ilium/ischium/pubis as indicated, hemostasis, possible pelvic reconstruction (internal fixation or allograft) if required, and placement of drains. Postoperative workflow includes monitoring in PACU or ICU depending on blood loss and complexity, pain control, early mobilization with physical therapy, wound care, pathology review confirming margins, adjuvant therapy planning if indicated, and coordination of claims submission with appropriate coding and modifiers for the surgical service and any associated professional or facility components.
Coding Specifications
| Modifier | Description | When to Use |
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