CPT 27105 Paraspinal Muscle Transfer Reimbursement | OpenPayer

Summary & Overview

CPT 27105: Paraspinal Muscle Transfer to Hip, Reconstructive Procedure

CPT code 27105 denotes a reconstructive orthopedic surgery in which a paraspinal muscle is transferred to the hip joint with a fascial or tendon graft. The procedure is clinically significant for restoring hip stability and function in complex cases where native soft-tissue support is inadequate. Nationally, accurate coding of this procedure matters for appropriate case classification, resource allocation, and surgical registry capture.

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 intent of the procedure, typical sites of service, and the service type. The publication summarizes common modifier usage when available, highlights billing and coding considerations, and outlines the clinical context in which the procedure is performed.

This report provides benchmarks and policy-relevant notes useful for billing teams, orthopedic surgical practices, and health plan analysts. It is intended to clarify what CPT code 27105 represents, where it is typically performed, and what stakeholders should expect in terms of documentation and coding categorization. Data not available in the input will be explicitly noted where relevant.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareCPT 27105orthopedic surgeryhip reconstructionsoft-tissue transfersurgical codingreconstructive procedureoperating roomprocedure coding

Billing Code Overview

CPT code 27105 describes a surgical procedure in which a provider transfers a paraspinal muscle to the hip joint using a fascial or tendon graft. This is a reconstructive orthopedic procedure performed to restore hip stability or function by redirecting muscular force vectors via a soft-tissue graft.

Service type: Surgical, reconstructive orthopedic procedure
Typical site of service: Inpatient or outpatient surgical setting (operating room) depending on clinical complexity and patient factors

Data not available in the input.

Clinical & Coding Specifications

Clinical Context

A typical patient is a 25–45-year-old adult who sustained a chronic hip abductor insufficiency following proximal femoral fracture, failed hip arthroplasty, or traumatic avulsion of the gluteal tendons. The patient presents with lateral hip pain, progressive limp, Trendelenburg gait, and weakness on resisted hip abduction despite conservative care (physical therapy, injections). Imaging (MRI) documents retracted or nonviable gluteus medius/minimus tendons and preserved paraspinal muscle donor tissue. After multidisciplinary review, the orthopedic surgeon performs a reconstruction in the operating room under general anesthesia: harvest of a fascial or tendon graft (autograft or allograft as indicated), mobilization and transfer of a paraspinal muscle unit with graft augmentation to the greater trochanter, and fixation with suture anchors or fixation devices. Typical perioperative workflow includes preoperative clearance, intraoperative neurovascular monitoring as needed, postoperative pain control, early protected ambulation with assistive device, and outpatient physical therapy for progressive strengthening and gait retraining.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	Use when work, time, or complexity substantially exceeds usual for `27105` (document rationale and time).

CPT 27187: Femoral Neck and Proximal Femur Fixation

CPT-27110-ILIOPSOAS-TRANSFER-GREATER-TROCHANTER

CPT 27110: Iliopsoas Transfer to Greater Trochanter

CPT-27125-FEMORAL-HEAD-REPLACEMENT-HEMIARTHROPLASTY-STABILIZATION

CPT 27125: Femoral Head Replacement (Hemiarthroplasty) for Stabilization

CPT-27098-ADDUCTOR-TENDON-TRANSFER-ISCHIAL-REATTACHMENT

CPT 27098: Adductor Tendon Transfer to Ischium

27130-ARTHROPLASTY-ACETABULAR-AND-PROXIMAL-FEMORAL-PROSTHETIC

CPT 27130: Total Hip Arthroplasty (Acetabular and Femoral Prosthetic Replacement)

CPT-27151-ILIAC-AND-FEMORAL-OSTEOTOMY-HIP-REALIGNMENT

CPT 27151: Iliac (Acetabular) and Femoral Osteotomy for Hip Realignment

CPT-27134-REVISION-TOTAL-HIP-ARTHROPLASTY-BOTH-COMPONENTS

CPT 27134: Revision Total Hip Arthroplasty, Femoral and Acetabular Components

CPT-27097-HAMSTRING-PROXIMAL-RELEASE

CPT 27097: Proximal Hamstring Release

CPT-27165-PROXIMAL-FEMUR-OSTEOTOMY-CORRECTIVE-ALIGNMENT

CPT 27165: Proximal Femoral Osteotomy for Alignment Correction

CPT-27111-ILIOPSOAS-TRANSFER-FEMORAL-NECK-HIP-STABILITY

CPT 27111: Iliopsoas Transfer to Femoral Neck for Hip Stability

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Taxonomy Code	Specialty	Notes
207L00000X	Orthopaedic Surgery	Primary specialty performing muscle/tendon transfer and hip reconstruction.
207T00000X	Orthopaedic Reconstructive Surgery	Subspecialty for complex revision hip and soft-tissue reconstructions.
2080P0206X	Physical Medicine & Rehabilitation	Manages perioperative rehabilitation and functional recovery.
2084P0800X	Physical Therapist	Provides outpatient therapy for gait and strengthening postoperatively.
208800000X	General Surgery	Occasionally involved in complex soft-tissue graft harvest or multidisciplinary cases.

ICD-10 Code	Description	Clinical Relevance
Data not available in the input.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`27096`	Reconstruction, open, for chronic hip instability (e.g., capsulorrhaphy, hip)	May be performed concurrently when hip instability is addressed alongside tendon transfer.
`23420`	Transfer or graft procedures for shoulder (e.g., tendon transfer) — representative upper extremity tendon transfer code	Functionally analogous procedure type; included when documenting tendon-transfer principles and coding parallels (used for clinical comparison, not performed on hip).
`20670`	Revision of closed or open treatment of tendon injury; secondary procedures such as tenolysis, complex tendon reconstruction	May be reported for additional tendon work or graft revisions performed during the same operative session.
`11042`	Debridement, muscle and/or fascia (first layer)	May be used if significant debridement of chronic scar tissue or nonviable muscle is required at the operative site.
`20926`	Allograft, large structural, or `20930` for bone grafting — (Note: specific code depends on graft type)	Report if structural allograft or bone grafting is required as part of fixation or reconstruction adjuncts.

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