CPT 27176 Percutaneous Pinning Reimbursement

CPT code 27176 covers closed percutaneous pinning for slipped femoral epiphysis, a pediatric orthopedic procedure to stabilize the proximal femoral growth plate after a slip or fracture. This procedure is nationally relevant because timely surgical stabilization reduces the risk of deformity, impaired hip function, and long-term arthropathy in adolescents. Billing clarity for this code affects surgical departments, pediatric orthopedic practices, and payers managing pediatric surgical benefits.

Key payers considered in typical coverage analyses include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise review of clinical context for the procedure, typical sites of service, and payer coverage considerations. The publication summarizes common utilization patterns, coding and billing considerations, and benchmark metrics where available. It also highlights policy and coverage elements that commonly affect authorization and reimbursement workflows for percutaneous pinning of slipped femoral epiphysis.

This overview is intended to inform coding staff, revenue cycle teams, and clinical leaders about the clinical purpose of CPT code 27176, the settings where the service is delivered, and the payer groups most commonly involved in coverage decisions. Data not available in the input are noted where relevant.

Billing Code Overview

CPT code 27176 describes closed treatment of slipped femoral epiphysis (slipped capital femoral epiphysis) using percutaneous pinning. The procedure involves inserting one or more pins through a small stab incision to stabilize the femoral epiphysis after a growth-plate–related slip or fracture.

Service type: Surgical fixation procedure (orthopedic, pediatric orthopedics)
Typical site of service: Hospital operating room or ambulatory surgical center for pediatric or adolescent patients

Clinical Context

A 13-year-old adolescent presents to the emergency department after progressive limp and hip pain over several weeks, with acute worsening after a fall. Radiographs confirm a slipped capital femoral epiphysis (SCFE) of the left proximal femur. The orthopedic surgeon plans a percutaneous in situ pinning using one or more cannulated screws to stabilize the epiphysis and prevent further slip.

Preoperative workflow includes informed consent, pre-op history and physical, anesthesia evaluation (general or regional), and surgical site marking. In the operating room, fluoroscopic imaging guides closed reduction when indicated and percutaneous placement of pins through small stab incisions. The procedure typically occurs in an ambulatory surgery center or hospital operating room, with postoperative monitoring in PACU and discharge instructions for weight-bearing status, follow-up radiographs, and outpatient orthopedic clinic visits for pin removal or further management as needed.

Coding Specifications

Modifier	Description	When to Use
`LT`	Left side	Use when the procedure is performed on the left femur/hip.
`RT`	Right side

Taxonomy Code	Specialty	Notes
207ZP0102X	Orthopaedic Surgery	Pediatric and general orthopedists perform SCFE fixation.
207RH0000X	Orthopaedic Surgery of the Hip	Specialists focused on hip disorders commonly manage complex slips.
163WL0200X	Pediatric Orthopedics	Pediatric orthopedic surgeons frequently treat SCFE in adolescents.
2080P0208X	General Surgery	May be involved in perioperative care in some settings.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`M93.00`	Slipped upper femoral epiphysis, unspecified hip, not elsewhere classified	Primary diagnosis for SCFE; directly indicates need for fixation.
`M93.01`	Slipped upper femoral epiphysis, right hip	Specific laterality when right hip is affected; supports `RT` modifier use.
`M93.02`	Slipped upper femoral epiphysis, left hip	Specific laterality when left hip is affected; supports `LT` modifier use.
`S72.001A`	Fracture of unspecified part of neck of right femur, initial encounter for closed fracture	Used when acute femoral neck fracture component is present or fracture coding parallels fixation.
`S72.002A`	Fracture of unspecified part of neck of left femur, initial encounter for closed fracture	Same as above for left side.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`27176`	Percutaneous fixation of slipped femoral epiphysis (SCFE) using pins or screws	Primary procedure code describing in situ pinning of the slipped femoral epiphysis.
`24538`	Closed treatment of proximal femoral fracture; with manipulation, with or without skeletal traction, with internal fixation, single or multiple screws	May be used if reduction and fixation of proximal femoral fracture elements are performed in older adolescents when coding parallels femoral neck/shaft fixation.
`20690`	Application of external fixation device (separate procedure), uniplane; initial application	Used when temporary external fixation is required before definitive pinning (rare for SCFE).
`27447`	Arthrotomy, with exploration, drainage, or debridement of joint; knee (for reference)	Data not directly related to hip pinning but may be used for joint procedures; include for completeness.
`11042`	Debridement; subcutaneous tissue (includes superficial debridement)	May be used for wound management if pin site infection requires debridement postoperatively.

OpenPayer

Summary & Overview

CPT 27176: Percutaneous Pinning for Slipped Femoral Epiphysis