CPT 27161 Femoral Neck Osteotomy Reimbursement | OpenPayer

Summary & Overview

CPT 27161: Femoral Neck Osteotomy, Corrective Osteotomy

CPT code 27161 designates a femoral neck osteotomy in which a wedge-shaped portion of the femoral neck is removed to correct femoral alignment. This corrective orthopedic procedure is important for treating deformities or malalignment that impair hip function, gait, or joint mechanics and may affect surgical planning, resource use, and post-operative rehabilitation nationally. Key payers considered in typical analyses include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will learn the clinical context of the procedure, typical sites of service, common payer coverage considerations, and the types of benchmarks analysts track for utilization and payment. The publication outlines service-line implications for hospitals and ambulatory surgical centers, discusses typical coding and billing issues that arise for corrective femoral osteotomies, and summarizes what national payers commonly evaluate for medical necessity and coverage. Data not available in the input is noted where applicable.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareCPT 27161femoral neck osteotomyorthopedic surgeryosteotomyhip surgeryambulatory surgical centerhospital servicesprocedure codingsurgical correction

Billing Code Overview

CPT code 27161 describes a femoral neck osteotomy involving removal of a wedge-shaped portion of the femoral neck to correct femoral alignment. The procedure is an open orthopedic corrective surgery performed on the proximal femur to realign the femoral neck relative to the femoral shaft and head.

Service type: Orthopedic surgical procedure — corrective osteotomy

Typical site of service: Hospital operating room or ambulatory surgical center

Clinical & Coding Specifications

Clinical Context

A typical patient is an active adolescent or young adult presenting with symptomatic femoroacetabular impingement, slipped capital femoral epiphysis sequelae, developmental coxa vara, or malunited proximal femoral fracture resulting in abnormal femoral neck-shaft alignment and hip pain or restricted range of motion. The patient has persistent groin or lateral hip pain, pain with pivoting or internal rotation, reduced hip flexion, and radiographic evidence of femoral neck deformity (e.g., coxa vara, excessive femoral anteversion/retroversion, cam lesion deformity). Conservative measures (activity modification, physical therapy, NSAIDs, and targeted injections) have failed or are insufficient.

Preoperative workflow includes history and physical examination, standing and frog-leg lateral radiographs, CT or MRI for 3D deformity assessment and planning, templating osteotomy correction (wedge size and orientation), medical clearance, and patient counseling regarding risks and expected recovery. Intraoperatively, the orthopedic surgeon performs a femoral neck osteotomy — removing a wedge-shaped portion of the femoral neck to correct alignment — often with internal fixation (e.g., plates, screws, pediatric/pelvic fixation devices) and possible concomitant hip arthroscopy or acetabular procedures. Postoperative care includes pain control, DVT prophylaxis, weight-bearing restrictions, serial radiographs to confirm union, and outpatient physical therapy until functional recovery.

Typical site of service: Hospital inpatient, Hospital outpatient (ambulatory surgery center when appropriate), or Ambulatory Surgery Center depending on patient comorbidity and concurrent procedures.

Typical providers involved: orthopedic surgeon specializing in adult reconstruction or pediatric orthopedics, anesthesiologist, perioperative nursing, radiology for intraoperative imaging, and physical therapy for rehabilitation.

Coding Specifications

CPT 27100: External Oblique Transfer to Greater Trochanter

CPT-27178-CLOSED-REDUCTION-PERCUTANEOUS-PINNING-SLIPPED-FEMORAL-EPIPHYSIS

CPT 27178: Closed Reduction and Percutaneous Pinning for Slipped Femoral Epiphysis

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

CPT 27098: Adductor Tendon Transfer to Ischium

CPT-27165-PROXIMAL-FEMUR-OSTEOTOMY-CORRECTIVE-ALIGNMENT

CPT 27165: Proximal Femoral Osteotomy for Alignment Correction

CPT-27151-ILIAC-AND-FEMORAL-OSTEOTOMY-HIP-REALIGNMENT

CPT 27151: Iliac (Acetabular) and Femoral Osteotomy for Hip Realignment

CPT-27138-FEMORAL-COMPONENT-REVISION-HIP-ARTHROPLASTY

CPT 27138: Revision Hip Arthroplasty, Femoral Component

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

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

CPT-27122-ACETABULOPLASTY-AND-FEMORAL-HEAD-RESECTION

CPT 27122: Acetabuloplasty with Femoral Head Resection

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Modifier	Description	When to Use
`22`	Increased procedural services	Use when the femoral neck osteotomy requires substantially greater work or complexity than typical, with documentation supporting the extra effort.
`24`	Unrelated E/M by same physician during postoperative period	Data not available in the input.
`50`	Bilateral procedure	Use when femoral neck osteotomies are performed on both hips during the same operative session.
`51`	Multiple procedures	Use when another distinct procedure is performed in the same operative session in addition to the osteotomy.
`52`	Reduced services	Use when the planned osteotomy is partially reduced or not fully performed.
`53`	Discontinued procedure	Use when the osteotomy is started but terminated due to unforeseen circumstances.
`62`	Two surgeons	Use when two surgeons work together as primary surgeons performing portions of the osteotomy.
`76`	Repeat procedure by same physician	Data not available in the input.
`78`	Unplanned return to the OR by same physician following initial procedure for a related procedure during the postoperative period	Use when return to the operating room is required for a complication related to the osteotomy.
`79`	Unrelated procedure or service during the postoperative period	Data not available in the input.
`LT`	Left side	Use to identify the left hip when billing a unilateral osteotomy.
`RT`	Right side	Use to identify the right hip when billing a unilateral osteotomy.
`AS`	Ambulatory surgery center facility service	Use to indicate the facility component in the ambulatory surgery center setting.
`26`	Professional component	Use when billing only the physician’s professional component separate from the facility or technical component for imaging or intraoperative fluoroscopy.

Taxonomy Code	Specialty	Notes
`207X00000X`	Orthopaedic Surgery	Primary specialty performing femoral neck osteotomy for deformity correction and fracture management.
`208000000X`	Orthopaedic Surgery of the Hip	Subspecialty focused on hip preservation, reconstruction, and osteotomy procedures.
`2086S0126X`	Pediatric Orthopaedic Surgery	Pediatric specialists perform osteotomies for developmental deformities and slipped capital femoral epiphysis sequelae.
`2084P0801X`	Orthopaedic Trauma	Trauma surgeons performing corrective osteotomies after malunions or complex proximal femoral fractures.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`M21.81`	Other acquired deformity, right upper limb	Data not available in the input.
`M21.82`	Other acquired deformity, left upper limb	Data not available in the input.
`M16.11`	Unilateral primary osteoarthritis, right hip	Common indication when hip deformity produces early joint degeneration addressed by corrective osteotomy or considered in planning.
`M21.61`	Acquired deformity of left lower limb	Relevant when femoral neck deformity is part of lower limb malalignment.
`M21.62`	Acquired deformity of right lower limb	Relevant when femoral neck deformity is part of lower limb malalignment.
`M84.36`	Nonunion of fracture, femur	Indication for corrective osteotomy when malunion or nonunion of proximal femur contributes to deformity and dysfunction.
`Q65.81`	Other congenital deformities of hip, right	Congenital hip deformities may require femoral neck osteotomy as part of reconstruction.
`Q65.82`	Other congenital deformities of hip, left	Congenital hip deformities may require femoral neck osteotomy as part of reconstruction.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`27130`	Arthroplasty, acetabular and proximal femoral prosthetic replacement (total hip arthroplasty)	Performed when deformity or joint degeneration is advanced and arthroplasty is indicated instead of or following osteotomy.
`27146`	Osteotomy, femoral, proximal, intertrochanteric, with or without fixation	Alternative proximal femoral osteotomy level (intertrochanteric) that may be performed instead of a femoral neck osteotomy depending on deformity.
`27279`	Open treatment of femoral shaft fracture, with or without internal fixation, includes osteotomy and fixation when needed	May be used when corrective osteotomy extends into proximal femoral shaft or when treating malunions involving the shaft.
`20690`	Application of external fixation system	Used when external fixation is used in conjunction with osteotomy for gradual correction or stabilization.
`73530`	Radiologic examination, femur; unilateral, minimum 2 views	Preoperative and postoperative radiographs used for planning and follow-up after femoral neck osteotomy.

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