CPT 27177 Open Fixation Reimbursement | OpenPayer

Summary & Overview

CPT 27177: Open Fixation for Slipped Femoral Epiphysis

CPT code 27177 denotes open surgical treatment of slipped femoral epiphysis using single or multiple pins or with grafting from another body site. This pediatric orthopaedic procedure stabilizes the femoral head after displacement through the physis and is critical for preventing long-term hip deformity and functional impairment. Nationally, procedures for slipped capital femoral epiphysis are clinically significant due to their impact on growth, mobility, and potential need for future reconstructive care.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a clinical context for the procedure, typical sites of service, and payer coverage patterns when available. The publication summarizes common billing considerations and related service-line positioning for orthopaedic surgery and pediatric care.

This report provides benchmarks where available, notes policy updates affecting coverage or prior authorization, and outlines coding-focused clinical context to help billing, compliance, and clinical teams understand where CPT code 27177 fits within surgical hip care for growing patients. Data not available in the input is identified explicitly in the supporting sections.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare27177CPTorthopaedic surgerypediatric orthopedicsslipped femoral epiphysiship fixationsurgical procedureoperating room

Billing Code Overview

CPT code 27177 describes an open surgical treatment for slipped femoral epiphysis using single or multiple pins or by using a graft obtained from another part of the body. This procedure addresses a pediatric orthopaedic condition in which the femoral head (epiphysis) slips off the femoral neck because of a growth plate (physis) fracture.

Service Type: Open orthopaedic surgical fixation or grafting for slipped femoral epiphysis

Typical Site of Service: Hospital operating room or ambulatory surgery center

Clinical & Coding Specifications

Clinical Context

A 13-year-old male presents to the emergency department with acute-onset left hip pain and limp after a minor fall while playing. Radiographs demonstrate a moderate slipped capital femoral epiphysis (SCFE) with posterior and inferior displacement of the femoral head relative to the neck. The orthopedic surgeon evaluates growth plate stability and decides on open reduction and internal fixation using multiple pins to stabilize the epiphysis. The patient is admitted for same-day or overnight observation. The clinical workflow includes preoperative evaluation (history, focused physical exam, consent), preoperative imaging (AP pelvis and frog‑leg lateral hip radiographs; CT or MRI if vascular compromise suspected), anesthesia evaluation, operative open reduction with percutaneous or open pin fixation and/or autograft harvest if required, intraoperative fluoroscopic confirmation of hardware position, postoperative analgesia and physical therapy initiation with non–weight bearing precautions, discharge planning with outpatient orthopedic follow‑up and radiographic monitoring for fixation stability and early complications such as avascular necrosis or chondrolysis.

Coding Specifications

The following modifiers are the most clinically relevant to 27177 in pediatric hip surgery and fixation.

Modifier	Description	When to Use
`22`	Increased procedural services

CPT 27100: External Oblique Transfer to Greater Trochanter

CPT-27140-GREATER-TROCHANTER-OSTEOTOMY-TRANSFER

CPT 27140: Greater Trochanter Osteotomy and Transfer

CPT-27187-FEMORAL-NECK-PROXIMAL-FEMUR-FIXATION

CPT 27187: Femoral Neck and Proximal Femur Fixation

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

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

CPT-27185-TROCHANTERIC-EPIPHYSIODESIS-GROWTH-MODULATION

CPT 27185: Trochanteric Epiphysiodesis for Proximal Femoral Growth Modulation

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

CPT 27122: Acetabuloplasty with Femoral Head Resection

CPT-27170-PROXIMAL-FEMUR-BONE-GRAFTING

CPT 27170: Bone Graft for Proximal Femoral Defect

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

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

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

CPT 27158: Pediatric Pelvic Osteotomy for Hip Stabilization

CPT-27110-ILIOPSOAS-TRANSFER-GREATER-TROCHANTER

CPT 27110: Iliopsoas Transfer to Greater Trochanter

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Taxonomy Code	Specialty	Notes
Data not available in the input.

Related Diagnoses

The most commonly associated ICD-10 codes for slipped capital femoral epiphysis and related indications for 27177 are listed below.

ICD-10 Code	Description	Clinical Relevance
`M93.04`	Slipped capital femoral epiphysis, left femur	Primary diagnosis indicating SCFE of the left hip requiring open treatment and fixation.
`M93.05`	Slipped capital femoral epiphysis, right femur	Primary diagnosis indicating SCFE of the right hip.
`M93.06`	Slipped capital femoral epiphysis, bilateral	Indicates bilateral involvement; may justify bilateral procedures or staged operations.
`S72.001A`	Fracture of head of right femur, initial encounter for closed fracture	Used if acute fracture of femoral head/epiphysis accompanies or causes the slip in trauma settings.
`S72.002A`	Fracture of head of left femur, initial encounter for closed fracture	Same as above for the left side.
`M24.50`	Joint derangement, unspecified site	Occasionally used when specific SCFE coding is not available in documentation (less preferred).

Related CPT Codes

The following CPT codes are commonly performed alongside or in the perioperative management of open treatment of slipped femoral epiphysis.

CPT Code	Description	Relationship to This Procedure
`27495`	Open treatment of proximal femoral fracture, includes internal fixation, when performed	May be used for open fixation of proximal femoral fractures or complex proximal femoral procedures when injury pattern overlaps with SCFE management.
`27370`	Closed treatment of proximal femoral epiphyseal slip (manipulation), without internal fixation	May be attempted prior to open treatment; documents closed reduction attempts when performed.
`20680`	Removal of implant; deep (e.g., buried pins, plates)	Used for later removal of internal fixation hardware placed during `27177` when clinically indicated.
`76000`	Fluoroscopic guidance (X‑ray) during procedure	Represents intraoperative imaging used to confirm reduction and hardware placement during `27177` (technical component reporting when required).
`11760`	Micrographic excision, malignant lesion; trunk, arms or legs, first stage	Data not available in the input.

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