CPT 27080 Coccygectomy Reimbursement & Policy | OpenPayer

Summary & Overview

CPT 27080: Coccygectomy, Removal of Coccyx

CPT code 27080 represents coccygectomy, the surgical removal of the coccyx (tail bone). Nationally, this code is used for definitive surgical management of recalcitrant coccygeal pain and other conditions involving the distal spine when conservative measures have failed. The procedure has implications for surgical specialty coding, facility billing, and post-operative care pathways.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical context for when 27080 is used, typical sites of service, and common billing considerations. The publication outlines benchmarking points, payer coverage patterns, and recent policy updates that affect authorization and documentation requirements. It also summarizes coding relationships relevant to surgical spine procedures and expected service lines.

This summary provides practical reference information for coding and payer engagement at a national level without state-specific detail. Data not available in the input has been noted where applicable.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare27080CPTcoccygectomyspine surgerysurgical procedureoutpatient surgeryoperating roomprocedure codingfacility billing

Billing Code Overview

CPT code 27080 describes the surgical removal of the coccyx (tail bone). This procedure is a surgical treatment performed to address conditions affecting the distal portion of the spine.

Service type: Surgical procedure
Typical site of service: Hospital operating room or outpatient surgical center

Clinical & Coding Specifications

Clinical Context

A typical patient is an adult with chronic coccygeal pain (coccydynia) refractory to conservative care who is scheduled for surgical coccygectomy (CPT 27080). The patient often presents after months to years of persistent tailbone pain following trauma (e.g., fall onto buttocks), degenerative changes, or post-partum coccygeal instability. Prior workup includes history and physical exam focusing on pain localization, imaging with lateral coccyx x-ray or MRI to evaluate fracture, subluxation, osteomyelitis, or neoplasm, and a trial of nonoperative therapies (NSAIDs, activity modification, cushion use, physical therapy, steroid injections, or coccygeal manipulation). When nonoperative measures fail and diagnostic injections correlate with symptom relief, the care team (orthopedic spine surgeon or colorectal surgeon with pelvic floor expertise) schedules CPT 27080 for partial or total coccygectomy.

Preoperative workflow includes informed consent, optimization of comorbidities, perioperative antibiotics, positioning prone, and marking of the surgical site. Intraoperative steps include a midline incision over the coccyx, soft tissue dissection, mobilization and removal of the coccyx, hemostasis, and layered closure. Postoperative care involves pain control, wound care, activity restrictions (avoiding sitting on the incision for several weeks), follow-up for wound checks, and rehabilitation as indicated. Typical site of service is an outpatient surgery center or hospital operating room under general or regional anesthesia. Common patient modifiers and documentation include anesthesia type, bilateral or multiple simultaneous procedures if applicable, and any unusual procedural circumstances documented by appropriate modifier coding.

Coding Specifications

Modifier	Description

CPT 27076: Radical Resection of Pelvic Tumor (Ilium/Acetabulum)

CPT-27065-EXCISION-BENIGN-BONE-LESION-ILIUM-PUBIS-TROCHANTER

CPT 27065: Excision of Superficial Bone Cyst or Benign Tumor

CPT-27049-PELVIC-HIP-SOFT-TISSUE-TUMOR-EXCISION-<5CM

CPT 27049: Pelvic/Hip Soft-Tissue Tumor Excision, <5 cm

CPT-27070-SUPERFICIAL-PARTIAL-EXCISION-ILIUM-PUBIS-GREATER-TROCHANTER

CPT 27070: Superficial Partial Excision of Ilium, Pubis, Greater Trochanter

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-27062-TROCHANTERIC-BURSA-EXCISION

CPT 27062: Excision of Trochanteric Bursa

CPT-27043-PELVIC-HIP-SUBCUTANEOUS-SOFT-TUMOR-EXCISION-3CM-PLUS

CPT 27043: Excision of Subcutaneous Soft Tissue Tumor, Pelvis/Hip ≥3 cm

CPT-27059-EXTENSIVE-PELVIS-HIP-SOFT-TISSUE-TUMOR-RESECTION-5CM-PLUS

CPT 27059: Extensive Pelvis/Hip Soft Tissue Tumor Resection, 5 cm or Larger

CPT-27050-OPEN-SACROILIAC-JOINT-BIOPSY

CPT 27050: Open Sacroiliac Joint Biopsy, Soft Tissue

CPT-27066-EXCISION-BENIGN-BONE-LESION-ILIUM-TROCHANTER

CPT 27066: Excision of Deep Bone Cyst or Benign Tumor with Reconstruction

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Taxonomy Code	Specialty	Notes
`2084P0805X`	Orthopaedic Surgery of the Spine	Orthopedic surgeons frequently perform coccygectomy for refractory coccydynia
`207XS0115X`	Colorectal Surgery	Colorectal surgeons manage complex coccygeal pathology and pelvic floor involvement
`2084P0809X`	Orthopaedic Surgery	General orthopedists in settings without a spine subspecialist may perform the procedure
`207K00000X`	Surgery, General	General surgeons may perform coccygectomy in select cases
`202R00000X`	Physical Medicine & Rehabilitation	PM&R physicians are often part of preoperative management and postoperative rehabilitation

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`M53.3`	Sciatica (coccydynia and related disorders often coded under dorsopathies)	Used when chronic pain localized to the coccyx and related dorsal spine disorders are documented
`M54.6`	Pain in thoracic spine (placeholder for dorsal pain syndromes)	Reflects axial spine pain; may be used when documentation specifies localized coccygeal pain
`M54.5`	Low back pain	May be used when documentation includes low back pain concurrent with coccygeal symptoms
`S32.5`	Fracture of coccyx	Direct traumatic fractures of the coccyx that may require surgical removal when nonoperative care fails
`M86.6`	Other osteomyelitis of pelvic bones	Osteomyelitis involving the coccyx may necessitate coccygectomy for source control

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`20610`	Arthrocentesis, aspiration and/or injection; major joint or bursa (e.g., hip, shoulder)	Diagnostic or therapeutic coccygeal injections (local anesthetic/steroid) are often performed prior to deciding on `CPT 27080` to confirm pain source
`72195`	Magnetic resonance (MR) imaging, pelvis; without contrast material	MR imaging of the pelvis may be used preoperatively to evaluate soft-tissue, infection, or neoplasm involving the coccyx
`72010`	Radiologic examination, spine, coccyx; two views	Plain radiographs of the coccyx are commonly obtained preoperatively for alignment, fracture, or subluxation assessment
`11042`	Debridement; skin, subcutaneous tissue, and muscle (e.g., for infected or necrotic wound)	May be performed concurrently or separately if infected or necrotic tissue around the coccyx requires debridement at time of coccygectomy
`99100`	Anesthesia for patient of extreme age, under 1 year or over 70 years, requiring special consideration (example)	Use in perioperative anesthesia coding when special age-related considerations affect management (supporting documentation required)

`11`	Standard or first-listed procedure performed by the surgeon	Use when `CPT 27080` is the primary procedure performed without unusual circumstances
`22`	Increased procedural services	Use when work required is substantially greater than usual and documentation supports increased effort (e.g., extensive adhesions, prior surgery)
`23`	Unusual anesthesia — medically necessary	Use when procedure is performed under general anesthesia because local/regional anesthesia is contraindicated due to medical condition
`26`	Professional component	Use only when reporting physician’s professional component separate from technical component (rare for this surgical procedure)
`50`	Bilateral procedure	Use when procedure is performed bilaterally (not typical for coccygectomy; generally not applicable)
`52`	Reduced services	Use when a reduced or partial coccygectomy is performed and documentation supports reduced service
`53`	Discontinued procedure	Use if procedure was started but terminated due to extenuating circumstances prior to completion
`59`	Distinct procedural service	Use when another separate procedure is performed at a distinct anatomic site or separate session
`62`	Two surgeons	Use when two surgeons with different specialties perform distinct portions of the same procedure (e.g., spine surgeon and colorectal surgeon)
`76` (Note: not in supplied list)	Data not listed — excluded	Data not available in the input.

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