Summary & Overview
CPT 27147: Pelvic Osteotomy with Hip Reduction
CPT code 27147 denotes a surgical pelvic osteotomy with reduction of a dislocated hip, targeting the iliac, acetabular, or innominate portions of the pelvic ring. This operative intervention is central to orthopedic care for certain congenital, developmental, or traumatic hip disorders where restoring joint alignment and stability is required. Nationally, the code captures resource use for complex reconstructive hip procedures that typically occur in inpatient surgical settings and, in selected cases, ambulatory surgical centers.
Key payers addressed in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication provides a compact set of benchmarks and policy-relevant insights for these commercial and federal payers.
Readers will find: an explanation of the clinical context and service setting for CPT code 27147; typical utilization patterns and where this procedure fits in orthopedic surgical portfolios; common billing and documentation considerations that affect claim processing; and an overview of payer coverage themes and reimbursement frameworks. Where data are not supplied in the input, the text notes that specific items are not available. The summary is intended for clinicians, billing professionals, and policy analysts seeking a concise national view of this complex pelvic osteotomy with hip reduction.
Billing Code Overview
CPT code 27147 describes an open surgical procedure in which the surgeon performs an osteotomy of the iliac, acetabular, or innominate bone of the pelvis and reduces a dislocated hip, restoring normal hip joint alignment. The procedure involves cutting and repositioning a portion of the pelvic bone (ilium, acetabulum, or innominate) to correct structural deformity and achieve stable hip reduction.
Service Type: Surgical — Orthopedic, Pelvic/Osteotomy with Hip Reduction
Typical Site of Service: Inpatient hospital operating room or ambulatory surgical center, depending on clinical complexity and patient status.
Clinical & Coding Specifications
Clinical Context
A typical patient is an adolescent or young adult presenting with symptomatic acetabular dysplasia or residual developmental hip dysplasia causing hip instability, early osteoarthritis, or recurrent subluxation. The patient reports groin pain, mechanical symptoms, and activity-related discomfort despite conservative care (physical therapy, activity modification, analgesics). Imaging (standing AP pelvis, false-profile, and CT or MRI as indicated) demonstrates acetabular insufficiency with lateral center-edge angle deficiency, abnormal acetabular version, or labral pathology.
Preoperative workflow includes orthopedic hip specialist evaluation, templating, and discussion of risks/benefits. Preoperative clearance, anesthesia evaluation, and perioperative planning for possible osteotomy fixation or concurrent arthroscopy occur. Intraoperatively the surgeon performs an acetabular or innominate osteotomy to reorient the acetabular socket, reduces the hip to restore congruency, and secures the osteotomy with internal fixation as needed. Postoperative care involves inpatient monitoring for pain control and neurovascular status, early mobilization with protected weight-bearing, physical therapy, and scheduled radiographic surveillance. Typical sites of service are the hospital operating room or ambulatory surgical center depending on complexity and inpatient needs. Service type is major surgical orthopedic procedure of the pelvis/hip (open osteotomy and reduction).
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services |