Summary & Overview
CPT 27170: Bone Graft for Proximal Femoral Defect
CPT code 27170 represents autogenous bone grafting for defects of the proximal femur, including the femoral head, neck, intertrochanteric, and subtrochanteric regions. This reconstructive orthopedic procedure restores bone integrity and supports joint or fracture repair, and it has implications for surgical complexity, resource utilization, and postoperative rehabilitation nationwide. Nationally, CPT code 27170 is relevant to hospitals, ambulatory surgical centers, orthopedic surgeons, and payers managing high-cost musculoskeletal care.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The analysis covers clinical context, expected sites of service, and payer coverage considerations that affect authorization, reimbursement pathways, and settings of care.
Readers will find benchmarks and comparative context for utilization and reimbursement (where available), summaries of clinical indications and service delivery settings, and notes on common modifiers used with this surgical code. The content provides a concise policy and billing-oriented overview for administrators, coders, and clinicians seeking to understand where CPT code 27170 fits within orthopedic procedural coding and payer workflows. Data not available in the input is noted where specific payer policy language, related ICD-10 diagnoses, and associated taxonomies are absent.
Billing Code Overview
CPT code 27170 describes a surgical procedure in which a provider treats a defect of the femoral head, femoral neck, intertrochanteric, or subtrochanteric region using a bone graft harvested from another area of the patient's body. This procedure is a form of orthopedic reconstructive surgery focusing on structural repair of the proximal femur.
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Service type: Autogenous bone grafting for proximal femoral defects
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Typical site of service: Inpatient or outpatient surgical setting, commonly performed in an operating room within a hospital or ambulatory surgical center
Clinical & Coding Specifications
Clinical Context
A 62-year-old male presents with progressive right hip pain and impaired ambulation after prior intertrochanteric fracture fixation that failed to heal and resulted in a bone defect of the femoral neck and intertrochanteric region. Imaging (radiographs and CT) demonstrates a nonunion with segmental bone loss and collapse of the femoral head. The orthopedic surgeon evaluates the patient in the preoperative clinic, documents indication for bone grafting to restore structural support and promote healing, obtains informed consent, and schedules an operative procedure under general or regional anesthesia. Intraoperatively the surgeon harvests autogenous cancellous or corticocancellous bone graft from the iliac crest, prepares the femoral defect by debridement, and implants the graft into the femoral head/neck/intertrochanteric area with fixation (plates, screws, or intramedullary devices) as indicated. Postoperative workflow includes pain control, wound checks, imaging to confirm graft placement and hardware, weight-bearing restrictions, and outpatient physical therapy for gradual rehabilitation. Hospital inpatient or ambulatory surgery center stay is determined by patient comorbidities and complexity of the case.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | Default/No modifier | Rarely appended; indicates no specific circumstance modifier if required by payer workflows |