Summary & Overview
CPT 27185: Trochanteric Epiphysiodesis for Proximal Femoral Growth Modulation
CPT code 27185 identifies a targeted orthopedic surgical procedure that implants screws or specialized staples into the epiphyseal region of the greater trochanter to temporarily arrest growth of the proximal femur. The code is used for procedures intended to modulate proximal femoral growth in pediatric and adolescent patients with growth-related deformities or limb-length discrepancies. Nationally, this code matters because it captures an elective, anatomically specific intervention with implications for specialty surgical billing, utilization monitoring, and facility resource planning.
Key payers included in the analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find clinical context explaining the procedure and typical sites of service, summaries of common billing modifiers and payer considerations, and a synthesis of available benchmarks and policy-relevant points. The publication provides guidance on documentation elements that commonly support medical necessity for growth modulation at the proximal femur and highlights billing scenarios and service-line planning for hospitals and ambulatory surgery centers.
Data not available in the input for specific associated taxonomies, ICD-10 diagnoses, related codes, or payer-specific fee schedules are noted where applicable.
Billing Code Overview
CPT code 27185 describes a surgical procedure in which the provider implants screws or specialized staples into the epiphyseal area of the greater trochanter of the femur to produce a temporary pause in growth of that bone. This intervention is a form of guided growth or epiphysiodesis targeting the proximal femur.
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Service type: Surgical orthopedic growth modulation procedure
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Typical site of service: Hospital operating room or ambulatory surgery center
Clinical & Coding Specifications
Clinical Context
A typical patient is an adolescent with symptomatic or progressive proximal femoral deformity due to slipped capital femoral epiphysis (SCFE) or developmental hip dysplasia requiring temporary modulation of growth at the greater trochanter. The patient presents to pediatric orthopedics with lateral hip pain, limp, or progressive trochanteric overgrowth noted on radiographs and physical exam. After clinical evaluation, imaging (anteroposterior and frog-leg lateral hip radiographs) confirms physis activity and pathology amenable to epiphysiodesis of the greater trochanter.
Preoperative workflow includes informed consent, perioperative medical clearance, and marking the operative limb. In the operating room under general anesthesia with fluoroscopic guidance, the surgeon places screws or specialized staples into the epiphyseal region of the greater trochanter to temporarily arrest growth. Intraoperative imaging documents hardware position. Typical recovery includes short inpatient observation or same-day discharge, postoperative analgesia, activity restriction, and scheduled radiographic follow-up to monitor physeal arrest and hardware position. Potential subsequent steps include hardware removal or conversion to definitive corrective procedures if needed as skeletal maturity approaches.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier—standard reporting | Use when no special modifier applies and standard global service is billed |
22 | Increased procedural services | Use when work, time, or complexity substantially exceeds typical for 27185 and documentation supports unusual service |
23 | Unusual anesthesia | Use when procedure is performed under general anesthesia in an emergency or when typical local/regional anesthesia is not appropriate |
26 | Professional component | Use when only the professional component is billed for a service that has a split billing arrangement (rare for 27185) |
50 | Bilateral procedure | Use when bilateral greater trochanter epiphysiodeses are performed and payer requires bilateral modifier reporting |
51 | Multiple procedures | Use when 27185 is reported with other distinct procedures in the same operative session to indicate multiple procedures were performed |
52 | Reduced services | Use when the procedure is started but not completed or is intentionally partially reduced |
53 | Discontinued procedure | Use when procedure is terminated due to extenuating circumstances or patient condition prior to completion |
62 | Two surgeons | Use when two surgeons work together as primary surgeons on the same operative day for the procedure |
63 | Procedure performed on infants less than 4 kg | Use when payer requires reporting of procedures on very low birth weight infants (rare applicability) |
76 | Repeat procedure by same physician | Use when the same physician repeats the procedure within the global period (not in provided modifier list; excluded) |
LT | Left side | Use to designate left-sided procedure when laterality is required by payer |
RT | Right side | Use to designate right-sided procedure when laterality is required by payer |
TC | Technical component | Use when only the technical component is billed (rare for surgical implant procedures) |
GC | Service performed in part by resident | Use when teaching physician documents resident participation per payer rules |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
| Data not available in the input. | Pediatric Orthopedic Surgery | Pediatric orthopedists commonly perform proximal femoral epiphysiodesis procedures |
| Data not available in the input. | Orthopedic Surgery | General orthopedic surgeons with pediatric experience may perform this procedure |
| Data not available in the input. | Pediatric Surgery | Pediatric surgeons in multidisciplinary centers may be involved in complex cases |
| Data not available in the input. | Physical Therapy | Postoperative rehabilitation providers manage gait and strength recovery |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
M93.05 | Juvenile osteochondrosis of femoral head (Perthes) | Growth modulation of the greater trochanter may be used in select pediatric proximal femoral growth disturbances |
M93.09 | Other juvenile osteochondrosis of hip and pelvis | Relevant for pediatric hip pathologies affecting growth and physis behavior |
M93.1 | Slipped upper femoral epiphysis | Primary indication in adolescents with SCFE requiring growth modulation or stabilization |
Q65.8 | Other congenital deformities of hip | Congenital deformities causing trochanteric prominence or proximal femoral growth issues may warrant epiphysiodesis |
M21.06 | Angular deformity, femur | Used when guided growth or epiphysiodesis is part of managing angular deformity of the proximal femur |
M25.551 | Pain in right hip | Symptom code supporting medical necessity when pain due to trochanteric overgrowth is present |
M25.552 | Pain in left hip | Symptom code supporting medical necessity for left-sided disease |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
27130 | Open treatment of femoral fracture, proximal end, including internal fixation | May be performed if proximal femoral fracture is present or if intraoperative conversion to fracture fixation is required |
27186 | Epiphysiodesis, femur, proximal, percutaneous | Alternative or adjacent code for growth modulation techniques involving the proximal femoral physis; may be used for similar indications depending on technique |
20690 | Insertion of implantable bone fixation device (implant removal/placement) | Used when specialized staples or implants are placed or later removed as a staged procedure |
73530 | Radiologic examination, hip, unilateral, complete, minimum 2 views | Preoperative and postoperative radiographs to document physis status and hardware position |
99024 | Postoperative follow-up visit global period | Used for routine postoperative follow-up care within the global period (billing depends on payer rules) |