CPT 27158 Pediatric Pelvic Osteotomy Reimbursement | OpenPayer

Summary & Overview

CPT 27158: Pediatric Pelvic Osteotomy for Hip Stabilization

CPT code 27158 represents a pediatric pelvic osteotomy performed to correct congenital pelvic alignment deformities and stabilize the hip by reshaping or repairing the acetabular side of the joint. This surgical procedure, including techniques such as Dega and Salter osteotomies, is important nationally as a standard intervention for developmental dysplasia of the hip and related pediatric hip disorders that can affect long-term mobility and function. Coverage and payment for this code affect hospital surgical workflows, inpatient and ambulatory surgical center utilization, and pediatric orthopedic service lines.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context for CPT code 27158, typical sites of service, and which payers commonly manage coverage for pediatric orthopedic reconstruction. The publication summarizes benchmark considerations and policy implications relevant to hospital billing and payer authorization processes, and provides clinical context to help nonclinical stakeholders understand why this code is used and how it fits into pediatric hip care pathways.

Data not available in the input for associated taxonomies, specific ICD-10 diagnosis pairings, and related procedure codes.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareCPT 27158pelvic osteotomypediatric orthopedicship reconstructionsurgical procedureacetabular osteotomyambulatory surgical centerinpatient surgery

Billing Code Overview

CPT code 27158 describes a pelvic osteotomy performed to correct congenital pelvic alignment deformities in children. The procedure involves incising or reshaping a portion of the pelvic bones or repairing the pelvic side of the hip socket (acetabulum) to stabilize the hip and restore more normal anatomy and function. Examples of techniques include Dega osteotomy and Salter osteotomy. The goal is correction of developmental pelvic/acetabular dysplasia and stabilization of the hip joint, typically in pediatric patients.

Service Type: Surgical — Pediatric Orthopedic Reconstruction

Typical Site of Service: Inpatient hospital or ambulatory surgical center, depending on patient age, complexity, and perioperative needs.

Clinical & Coding Specifications

Clinical Context

A 3-year-old child with developmental dysplasia of the hip (DDH) presents with limited hip abduction and an asymmetric gait. Conservative management with harnessing failed, and imaging (AP pelvis radiographs and pelvic CT when indicated) demonstrates a shallow acetabulum with lateralization of the femoral head. The orthopedic surgeon schedules a unilateral pelvic osteotomy (for example, a Dega or Salter-type osteotomy) to reorient and deepen the acetabular socket and stabilize the hip. The typical workflow includes preoperative assessment (history, physical exam, imaging, informed consent), general anesthesia with perioperative antibiotics, surgical exposure of the pelvic bone, osteotomy and repositioning of the acetabular fragment, fixation as indicated (pins or screws), intraoperative imaging to confirm reduction, postoperative immobilization (spica cast) or abduction brace, and scheduled follow-up with radiographs to monitor healing and hip stability.

Coding Specifications

Modifier	Description	When to Use
`51`	Multiple procedures	When additional distinct CPT-coded procedures are performed during the same operative session in addition to the pelvic osteotomy.
`52`	Reduced services

CPT 27161: Femoral Neck Osteotomy, Corrective Osteotomy

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

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

27130-ARTHROPLASTY-ACETABULAR-AND-PROXIMAL-FEMORAL-PROSTHETIC

CPT 27130: Total Hip Arthroplasty (Acetabular and Femoral Prosthetic Replacement)

CPT-27147-PELVIC-OSTEOTOMY-WITH-HIP-REDUCTION

CPT 27147: Pelvic Osteotomy with Hip Reduction

CPT-27179-FEMORAL-NECK-OSTEOTOMY-SLIPPED-EPIPHYSIS

CPT 27179: Femoral Neck Osteotomy for Slipped Femoral Epiphysis

CPT-27156-PELVIC-AND-FEMORAL-OSTEOTOMY-HIP-REDUCTION

CPT 27156: Pelvic and Femoral Osteotomy with Hip Reduction

CPT-27181-INTERTROCHANTERIC-OSTEOTOMY-SLAP-FEMORAL-EPIPHYSIS-INTERNAL-FIXATION

CPT 27181: Intertrochanteric Osteotomy for Slipped Femoral Epiphysis with Fixation

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

CPT 27100: External Oblique Transfer to Greater Trochanter

CPT-27134-REVISION-TOTAL-HIP-ARTHROPLASTY-BOTH-COMPONENTS

CPT 27134: Revision Total Hip Arthroplasty, Femoral and Acetabular Components

CPT-27176-PERCUTANEOUS-PINNING-SLIPPED-FEMORAL-EPIPHYSIS

CPT 27176: Percutaneous Pinning for Slipped Femoral Epiphysis

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Taxonomy Code	Specialty	Notes
Data not available in the input.	Pediatric Orthopedic Surgery	Pediatric orthopedic surgeons most commonly perform pelvic osteotomies for DDH and other developmental deformities.
Data not available in the input.	Orthopedic Surgery	General orthopedic surgeons with pediatric fellowship or experience perform open pelvic osteotomies.
Data not available in the input.	Pediatric Surgery / Pediatric Orthopedics	In some centers, pediatric orthopedic teams coordinate perioperative care and follow-up.
Data not available in the input.	Anesthesiology	Pediatric anesthesiologists provide general anesthesia and perioperative pain management.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`Q65.0`	Congenital coxa valga/other congenital deformities of hip	Developmental hip deformities that may require pelvic osteotomy to correct acetabular dysplasia and improve hip stability.
`Q65.1`	Congenital coxa vara	Hip alignment abnormality potentially addressed with pelvic and/or femoral osteotomies.
`Q65.8`	Other congenital deformities of hip	Miscellaneous congenital hip deformities that can be indications for corrective pelvic osteotomy.
`M16.11`	Unilateral primary osteoarthritis, right hip	Secondary osteoarthritis from longstanding dysplasia may lead to reconstructive procedures; less common in very young children but relevant in older pediatric/adolescent patients.
`M16.12`	Unilateral primary osteoarthritis, left hip	See `M16.11` for clinical relevance on the contralateral hip.
`M24.351`	Other specific joint derangements, right hip	Post-traumatic or developmental derangements that can be addressed with osteotomy to restore mechanics.
`M24.352`	Other specific joint derangements, left hip	Same as `M24.351` for the left hip.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`27146`	Reconstruction, acetabular and proximal femoral osteotomy, with or without internal fixation, pelvic and proximal femur; open procedure	May be used for combined pelvic and femoral osteotomies when both acetabular and proximal femoral procedures are performed in the same operative episode.
`27506`	Open treatment of femoral shaft fracture, includes internal fixation, when performed	May be reported if femoral osteotomy or fixation of the proximal femur is performed concurrently or if a femoral osteotomy is required to correct deformity in conjunction with pelvic osteotomy.
`20690`	Removal of implant; deep (e.g., buried wire, pin, screw) requiring incision, dissection and removal	Used for later removal of internal fixation hardware placed during the pelvic osteotomy if clinical course requires hardware removal.
`73540`	Radiologic examination, hip, unilateral; 1 or 2 views	Preoperative or postoperative radiographs to document acetabular morphology and healing.
`73542`	Radiologic examination, hip, unilateral; complete, minimum of 3 views	More extensive radiographic series used for detailed assessment pre- or postoperatively.

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