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.
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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.
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Service type: Surgical, reconstructive orthopedic procedure
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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). |
26 | Professional component | Use when reporting only the surgeon's professional component separate from technical facility charges (rare for operative codes). |
50 | Bilateral procedure | Use when bilateral paraspinal-to-hip transfers are performed and payer rules allow bilateral reporting (document laterality). |
51 | Multiple procedures | Use when 27105 is performed in the same session with other unrelated procedures; sequence per payer rules. |
52 | Reduced services | Use when the procedure is partially discontinued or less extensive than described by 27105 (document reason). |
53 | Discontinued procedure | Use when the procedure is started but terminated due to extenuating circumstances prior to completion (document reason). |
62 | Two surgeons | Use when two surgeons of different specialties perform distinct portions of the operative procedure concurrently (document roles). |
63 | Procedure performed on infants less than 4 kg | Typically not applicable but available when patient meets weight criteria. |
78 | Return to operating room for a related procedure during the global period | Use when a postoperative complication requires reopening the operative site within the global period. |
80 | Assistant surgeon | Use when an assistant surgeon provides intraoperative assistance and billing requires an assistant modifier. |
81 | Minimum assistant surgeon | Use when a minimal assistant role is documented and payer recognizes 81 instead of 80. |
82 | Assistant surgeon when a qualified resident surgeon not available | Use when an assistant is needed but a resident is unavailable. |
76 | Repeat procedure by same physician | Data not provided in input list; not included. |
| 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. |
Related Diagnoses
| 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. |