CPT 27110: Iliopsoas Transfer to Greater Trochanter
CPT code 27110 represents an orthopedic surgical procedure in which the iliopsoas muscle is transferred from the lesser trochanter to the greater trochanter to address weak hip abductors and improve lateral hip stability. The code captures a reconstructive muscle/tendon transfer that can affect patient mobility, rehabilitation trajectories, and surgical resource utilization nationwide. It matters clinically for surgical planning and post-operative rehabilitation, and administratively for procedure classification and billing consistency.
Key payers included in this analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical intent and typical settings, a summary of common billing modifiers and service-line considerations, and a framework for comparing payer coverage approaches and reimbursement benchmarks where available. The publication also outlines the expected surgical context, typical sites of service, and operational implications for hospitals and ambulatory surgical centers.
This summary is intended for national audiences including health plan analysts, surgical providers, revenue cycle professionals, and policy analysts who need a clear, clinically grounded description of CPT code 27110 and the practical billing and coverage context associated with iliopsoas-to-greater-trochanter transfer procedures. Data not available in the input are noted as such in relevant sections.
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Billing Code Overview
CPT code 27110 describes a surgical transfer of the iliopsoas muscle from the lesser trochanter to the greater trochanter of the femur. The procedure is performed to compensate for weak hip abductor muscles by repositioning the iliopsoas insertion to improve lateral hip stability and gait mechanics.
Service type: Orthopedic reconstructive procedure, tendon/muscle transfer
Typical site of service: Inpatient or outpatient surgical setting, commonly performed in hospital operating rooms or ambulatory surgical centers
Clinical & Coding Specifications
Clinical Context
A typical patient is an adolescent or young adult with abductor mechanism insufficiency causing hip instability or Trendelenburg gait, commonly after neuromuscular conditions, congenital hip disorders, or failed prior hip surgery. The patient presents with lateral hip pain, limp, and positive Trendelenburg sign. Preoperative workup includes history and physical exam, gait assessment, pelvic and hip radiographs, and often MRI to evaluate muscle integrity. The operative plan is a transfer of the iliopsoas tendon from the lesser trochanter to the greater trochanter (27110) to improve hip abductor function.
Workflow: outpatient or inpatient orthopedic evaluation → preoperative clearance and imaging → informed consent and anesthesia evaluation → operative procedure performed in an operating room with fluoroscopic or open exposure of the proximal femur → intraoperative confirmation of tendon transfer and fixation → postoperative recovery with pain control and physical therapy initiation, weight-bearing restrictions, and follow-up visits for wound check and functional assessment.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | Unspecified — not commonly used in billing | Rarely used; typically not appended to operative CPTs in standard claims |
22 | Increased procedural services | Use when work required is substantially greater than usual for 27110 (document increased complexity) |
23 | Unusual anesthesia | Use when procedure is performed under general anesthesia for an emergency or when local/regional anesthesia is contraindicated |
26 | Professional component | Use when separately reporting physician professional component for diagnostic services (rare for this surgical code) |
50 | Bilateral procedure | Use if identical procedure is performed on both hips during the same operative session (if payer allows bilateral reporting) |
51 | Multiple procedures | Use when 27110 is billed with other distinct surgical procedures during the same operative session |
52 | Reduced services | Use when the service is partially reduced or not completed as documented (e.g., aborted transfer) |
53 | Discontinued procedure | Use when procedure is terminated due to extenuating circumstances after anesthesia induction but before completion of transfer |
62 | Two surgeons | Use when two surgeons of different specialties work together as primary surgeons performing distinct portions of 27110 |
78 | Unplanned return to OR | Use when patient requires return to the operating room for a related procedure during the global period (e.g., revision of transfer) |
79 | Unrelated procedure during global period | Use when an unrelated procedure is performed during the global period (not commonly appended to primary orthopedic procedure) |
80 | Assistant surgeon | Use when an assistant at surgery performs portions of the procedure (may require specific assistant modifier per payer) |
81 | Minimum assistant surgeon | Use where a minimal assistant surgeon role is reported per payer policy |
82 | Assistant surgeon when qualified resident not available | Use when a qualified resident is not available and an assistant surgeon is required |
LT | Left side | Use to indicate the procedure was performed on the left hip when laterality is required |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
| 207X00000X | Orthopedic Surgery | Primary specialty performing 27110; expertise in hip reconstructive procedures |
| 207L00000X | Pediatric Orthopedic Surgery | Common when procedure is performed for developmental or neuromuscular conditions in children and adolescents |
| 208100000X | Physical Medicine & Rehabilitation | Involved in postoperative rehabilitation planning and functional assessment |
| 208600000X | Neurology (Clinical) | Consult when neuromuscular disease contributes to hip abductor weakness |
| 208200000X | General Surgery | May be involved rarely in multidisciplinary complex cases or revisions |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
M16.11 | Unilateral primary osteoarthritis of right hip | Arthritis causing abductor dysfunction and pain; may necessitate adjunctive soft-tissue procedures |
M16.12 | Unilateral primary osteoarthritis of left hip | See above for left-sided disease when abductor transfer is considered |
M62.81 | Muscle weakness (generalized) | Describes muscle weakness that may include hip abductors prompting surgical transfer when refractory to therapy |
G71.3 | Mitochondrial myopathy, not elsewhere classified | Example neuromuscular condition causing hip abductor insufficiency considered in surgical planning |
Q65.8 | Other congenital deformities of hip | Developmental hip abnormalities leading to gait disturbance addressed by tendon transfer |
M21.10 | Acquired deformity of hip, unspecified | Acquired deformities affecting abductor mechanics where transfer may be indicated |
S73.011A | Sprain of right hip joint, initial encounter | Traumatic injury leading to chronic abductor insufficiency in select cases |
Z96.64 | Presence of orthopedic joint implant, hip, right | Relevant when prior implants exist and may impact surgical approach or require removal |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
27030 | Excision or resection of bone, proximal femur; trochanteric region | May be performed to address bony impingement or prepare greater trochanter for tendon fixation during 27110 |
27415 | Tenodesis of knee extensor or flexor tendons (includes harvest and fixation) | Analogous tendon fixation technique; listed when additional soft-tissue procedures are required in complex reconstruction (technique similarity) |
20680 | Removal of implant; deep (e.g., buried screw) | Performed if existing hardware around the proximal femur must be removed before iliopsoas transfer |
27058 | Arthrotomy, hip, with synovectomy | May be performed if intraarticular pathology is addressed during the same operative session as 27110 |
27370 | Open treatment of femoral neck fracture, includes internal fixation | Performed in trauma settings where hip abductor reconstruction is part of complex proximal femoral surgery |