CPT 27111: Iliopsoas Transfer to Femoral Neck for Hip Stability
CPT code 27111 represents a specialized orthopedic surgical procedure in which the iliopsoas muscle is transferred to the neck of the femur to improve lateral stability of the hip in patients with weakened hip abductor function. This reconstructive muscle-tendon transfer has implications for mobility, fall risk reduction, and functional outcomes following hip instability or abductor deficiency. Nationally, accurate coding for this procedure matters for clinical documentation, quality measurement, and appropriate payment for complex orthopedic surgery.
Major payers typically addressed in national analyses include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical context for the procedure, an overview of expected service setting and service type, and notes on common billing modifiers when data is available. The publication summarizes benchmarks and policy-relevant considerations such as coding specificity, typical sites of service, and alignment with surgical care pathways. The summary is intended to orient clinicians, coding professionals, and policy analysts to the code's clinical purpose and where to look for payer-specific coverage or reimbursement details. Data not available in the input is noted where applicable.
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Billing Code Overview
CPT code 27111 describes a surgical iliopsoas transfer to the femoral neck performed to improve lateral hip stability by compensating for weak hip abductor muscles. The procedure involves detaching and relocating the iliopsoas muscle tendon to the neck of the femur to restore or enhance abductor function and hip joint stability.
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Service type: Orthopedic reconstructive procedure (muscle transfer) intended to address hip abductor insufficiency and lateral instability.
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Typical site of service: Inpatient or outpatient surgical setting, most commonly performed in an operating room within a hospital or ambulatory surgery center.
Clinical & Coding Specifications
Clinical Context
A typical patient for 27111 is an adolescent or young adult with chronic hip abductor insufficiency (for example, persistent Trendelenburg gait and lateral hip instability) following neuromuscular conditions, failed prior soft-tissue procedures, or congenital hip dysplasia. The patient commonly presents with lateral hip pain, gait deviation, and weakness on clinical exam. Imaging (radiographs, MRI) documents preserved femoral head structure but functional abductor deficiency. Conservative measures (physical therapy, bracing, activity modification) have been attempted without adequate functional improvement. The orthopedic surgical workflow includes preoperative evaluation with history and physical, gait analysis when available, informed consent discussing goals and risks, preoperative anesthesia evaluation, and perioperative antibiotic prophylaxis. Intraoperatively the iliopsoas tendon is identified, mobilized, and transferred to the femoral neck region to augment lateral stability; concurrent procedures (e.g., open reduction, corrective osteotomy) may be staged or performed as indicated. Postoperative care involves pain control, protected weight-bearing, physical therapy focused on gait retraining, and scheduled follow-up with serial clinical and radiographic assessment to document improved hip stability and function.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when work required is substantially greater than typical for 27111 due to complexity or extended time. |
52 | Reduced services | Use when the procedure is partially reduced or not completed as originally planned. |
53 | Discontinued procedure | Use when the procedure is started but stopped due to patient condition or intraoperative findings. |
62 | Two surgeons | Use when two surgeons of different specialties perform distinct portions of the 27111 procedure. |
63 | Procedure performed on infants less than 4 kg | Use only when applicable to very small pediatric patients meeting weight criteria. |
66 | Surgical team (multiple surgeons) | Use when a surgical team concept applies for complex cases requiring multiple surgeons. |
78 | Return to OR for related procedure during global period | Use for an unplanned return to the operating room for a related intraoperative complication of 27111. |
79 | Unrelated procedure or service by the same physician during postoperative period | (Note: 79 not listed in raw modifiers; not included.) |
50 | Bilateral procedure | Use when 27111 is performed bilaterally (modifier indicating bilateral surgical procedures may instead be represented by bilateral billing rules or two line items; apply payer guidance). |
51 | Multiple procedures | Use when 27111 is reported with additional distinct procedures during the same operative session. |
59 | Distinct procedural service | (Note: 59 not listed in raw modifiers; not included.) |
26 | Professional component | Use when reporting only the professional component separate from technical component (rare for this procedure). |
TC | Technical component | Use when reporting only the technical component (rare for this procedure). |
AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | Use when an advanced practice clinician served as the assistant at surgery as recognized by the payer. |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
| 207V00000X | Orthopaedic Surgery | Primary specialty performing 27111 procedures for hip abductor reconstruction. |
| 2080P0005X | Pediatric Orthopedic Surgery | Subspecialty for pediatric patients with congenital or developmental hip conditions requiring transfer. |
| 207L00000X | Sports Medicine (Orthopaedic) | May perform procedure for young active patients with abductor insufficiency related to trauma or overuse. |
| 206E00000X | Physical Medicine & Rehabilitation | Involved in pre- and postoperative functional assessment and rehabilitation planning. |
| 208000000X | General Surgery (if applicable as assistant) | May be listed as assisting specialty in complex cases (less common). |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
M16.11 | Unilateral primary osteoarthritis of right hip | May be associated with abductor weakness and instability leading to transfer consideration when pain and instability coexist. |
M16.12 | Unilateral primary osteoarthritis of left hip | As above for the contralateral side. |
M25.651 | Pain in right hip | Symptom prompting evaluation for procedures to restore stability and reduce pain. |
M25.652 | Pain in left hip | Symptom prompting evaluation for procedures to restore stability and reduce pain. |
M21.07 | Congenital deformity of pelvis and thigh, unspecified | Developmental or congenital hip conditions can lead to abductor insufficiency requiring muscle transfer. |
G81.90 | Hemiplegia, unspecified affecting unspecified side | Neuromuscular causes of abductor weakness (e.g., post-stroke hemiplegia) that may result in gait instability addressed by transfer. |
Q65.9 | Congenital deformity of hip, unspecified | Developmental dysplasia of the hip and related deformities that may require surgical soft-tissue balancing. |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
27130 | Arthroplasty, acetabular and proximal femoral prosthetic replacement (total hip arthroplasty), with or without autograft or allograft | Performed instead of or after failed soft-tissue reconstructions when joint degeneration necessitates total hip replacement. |
23420 | Tenotomy, shoulder (example of tendon transfer family) | Represents tendon transfer/tenotomy category; analogous conceptually to muscle-tendon transfer techniques like 27111 (illustrative). |
27330 | Reconstruction, hip, with osteotomy (e.g., femoral osteotomy) | May be performed in combination or staged when skeletal realignment is required to optimize abductor mechanics. |
27095 | Arthrotomy, hip, diagnostic or therapeutic | May be performed for joint inspection or to address intra-articular pathology discovered during 27111. |
15877 | Tissue rearrangement, thigh | Soft-tissue procedures for contour or additional soft-tissue balancing that can accompany muscle transfer surgeries. |