CPT 27156 Pelvic & Femoral Osteotomy Reimbursement | OpenPayer

Summary & Overview

CPT 27156: Pelvic and Femoral Osteotomy with Hip Reduction

CPT code 27156 covers combined pelvic (iliac/acetabular/innominate) osteotomy with femoral osteotomy and reduction of a dislocated hip. This complex orthopedic surgical code captures procedures intended to correct hip dislocation and malalignment by reshaping the acetabulum or innominate bone and realigning the femur. It is clinically significant for pediatric and adult patients with developmental dysplasia of the hip, traumatic dislocation, or acetabular deformities that require concurrent pelvic and femoral corrective osteotomies.

Key payers typically involved in national coverage and payment policies include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical intent and typical sites of service, plus coverage and billing considerations relevant to major commercial and federal payers. The publication provides benchmarks and policy context for reimbursement coding, common modifier usage, and coding interactions, along with clinical context about when combined pelvic and femoral osteotomies with hip reduction are performed. Where specific input data is unavailable, the text notes that data is not available in the input.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareCPT 27156pelvic osteotomyfemoral osteotomyhip reductionorthopedic surgeryambulatory surgeryinpatient surgeryhip dysplasiaprocedure coding

Billing Code Overview

CPT code 27156 describes a combined pelvic and femoral osteotomy with reduction of a dislocated hip. The procedure involves cutting a portion of the iliac, acetabular, or innominate bone of the pelvis (pelvic osteotomy) to reshape or reorient the hip socket, followed by reduction of the dislocated hip and a femoral osteotomy in which the femur is cut to correct alignment.

Service type: Surgical orthopedic procedure — pelvic (acetabular/innominate/iliac) osteotomy with femoral osteotomy and hip reduction
Typical site of service: Inpatient or outpatient surgical setting, commonly performed in an operating room within a hospital or ambulatory surgery center

Clinical & Coding Specifications

Clinical Context

A typical patient is a pediatric or young adult patient with developmental dysplasia of the hip (DDH), neglected hip dislocation, neuromuscular hip deformity, or post-traumatic malalignment who presents with hip pain, limited range of motion, gait disturbance, or leg-length discrepancy. The clinical workflow begins with outpatient evaluation by an orthopedic surgeon, including history, physical exam, and imaging (radiographs, CT or MRI as indicated). When conservative measures and closed reduction are not feasible or have failed, the surgeon schedules an operative open pelvic osteotomy with concomitant femoral osteotomy to reorient the acetabulum and correct femoral alignment. The procedure is performed in an operating room under general anesthesia with possible regional block for analgesia. Intraoperative steps include exposure of the pelvic ring and acetabulum, performance of an ilium/acetabular/innominate osteotomy to improve femoral head coverage, reduction of the hip, and femoral osteotomy (varus, derotational, or shortening) with internal fixation (plates, screws, or intramedullary devices). Postoperative care includes inpatient monitoring for pain control and neurovascular status, DVT prophylaxis, physical therapy for protected weightbearing, and serial radiographs to evaluate osteotomy healing. Typical follow-up occurs at 2 weeks, 6 weeks, 3 months, and until radiographic union and functional recovery.

Coding Specifications

Modifier	Description	When to Use
`11`	Normal, uncomplicated procedure	Use when the service is the primary procedure performed without unusual circumstances.

CPT 27165: Proximal Femoral Osteotomy for Alignment Correction

CPT-27158-PELVIC-OSTEOTOMY-PEDIATRIC-HIP-RECONSTRUCTION

CPT 27158: Pediatric Pelvic Osteotomy for Hip Stabilization

CPT-27100-EXTERNAL-OBLIQUE-TRANSFER-HIP-ABDUCTOR-RECONSTRUCTION

CPT 27100: External Oblique Transfer to Greater Trochanter

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

CPT 27098: Adductor Tendon Transfer to Ischium

CPT-27140-GREATER-TROCHANTER-OSTEOTOMY-TRANSFER

CPT 27140: Greater Trochanter Osteotomy and Transfer

CPT-27177-OPEN-FIXATION-SLIPPED-FEMORAL-EPIPHYSIS

CPT 27177: Open Fixation for Slipped Femoral Epiphysis

CPT-27146-PELVIC-OSTEOTOMY-ILIAC-ACETABULAR-INNOMINATE-BONE

CPT 27146: Pelvic Osteotomy — Iliac/Acetabular/Innominate Bone

CPT-27170-PROXIMAL-FEMUR-BONE-GRAFTING

CPT 27170: Bone Graft for Proximal Femoral Defect

CPT-27110-ILIOPSOAS-TRANSFER-GREATER-TROCHANTER

CPT 27110: Iliopsoas Transfer to Greater Trochanter

CPT-27105-PARASPINAL-MUSCLE-TRANSFER-TO-HIP-RECONSTRUCTIVE

CPT 27105: Paraspinal Muscle Transfer to Hip, Reconstructive Procedure

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Taxonomy Code	Specialty	Notes
`207X00000X`	Orthopaedic Surgery	Primary specialty performing pelvic and femoral osteotomies.
`2080P0250X`	Pediatric Orthopedic Surgery	Subspecialty for pediatric DDH and developmental hip procedures.
`2086S0123X`	Orthopedic Trauma Surgery	Performs osteotomies related to complex post-traumatic deformity.
`207L00000X`	Orthopedic Sports Medicine	May perform complex hip-preserving osteotomies in young adults.
`363A00000X`	Anesthesiology	Provides anesthesia care for these major reconstructive procedures.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`Q65.8`	Other congenital deformities of hip	Relevant for developmental dysplasia or congenital hip deformities requiring osteotomy and reduction.
`Q65.1`	Congenital dislocation of hip, unilateral	Coded when the patient has congenital dislocation treated with pelvic and femoral osteotomies.
`M16.9`	Osteoarthritis of hip, unspecified	May be relevant in older patients with secondary degenerative changes prompting reconstruction or later arthroplasty.
`M21.25`	Other acquired deformity, femur	Applied when femoral deformity necessitates corrective osteotomy.
`S73.001A`	Dislocation of right hip, initial encounter	Used for acute or subacute hip dislocations that may require open reduction and osteotomy if chronic or complex.
`S73.002A`	Dislocation of left hip, initial encounter	As above for the left hip.
`M23.20`	Derangement of meniscus due to old tear or injury, unspecified knee	Not directly related to hip osteotomy; Data not available in the input.
`M24.861`	Other specific joint derangements of hip	Used for instability or chronic derangement leading to reconstructive osteotomy.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`27096`	Osteotomy, iliac or innominate, with or without internal fixation	May be reported when a standalone iliac/innominate osteotomy is performed; often related as the pelvic component of `27156` when reported separately under specific circumstances.
`27146`	Arthroplasty, acetabular and proximal femoral prosthetic replacement (total hip arthroplasty)	May be performed later in the patient lifecycle for post-traumatic or degenerative progression after osteotomy in older patients.
`27485`	Osteotomy, femur, proximal, with or without internal fixation	Describes proximal femoral osteotomy; often reported when surgical documentation separates femoral osteotomy from pelvic osteotomy.
`20690`	Removal of implant; deep (e.g., buried wire, pin, screw, metal band, nail, or rod)	May be performed in a subsequent procedure to remove hardware placed during `27156` after union.
`27370`	Open treatment of femoral fracture, proximal (e.g., intertrochanteric, subtrochanteric)	Related when intraoperative fractures occur or when osteotomy is performed as part of fracture management.
`20999`	Unlisted procedure, musculoskeletal system, general — specify	Used only if a documented procedure does not have a specific CPT equivalent; rare for this clinical scenario.

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