CPT 27215: Open Fixation of Iliac Spine/Tuberosity/Iliac Wing Fracture
CPT code 27215 denotes open surgical treatment for avulsion fractures of the iliac spine, iliac tuberosity, or iliac wing with internal fixation. This code captures a definitive orthopedic procedure to reduce and stabilize unilateral pelvic fractures that involve the iliac crest or adjacent tuberosity structures. Nationally, it is relevant for trauma, sports injury, and postoperative care pathways where accurate coding affects operative reporting and claims adjudication.
Key payers addressed in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical context for when CPT code 27215 is reported, typical sites of service, and the procedural intent of open fixation. The publication also outlines common billing modifiers associated with operative services and highlights benchmarking areas important to hospital and surgical practice managers.
The report provides: (1) an executive clinical description for coding and case identification; (2) a summary of payer coverage considerations and commonly seen modifiers in claims; and (3) guidance on where to look for related coding and billing policy updates. Data not available in the input are noted where applicable.
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Billing Code Overview
CPT code 27215 describes an open treatment of iliac spine, tuberosity avulsion, or iliac wing fractures on one side of the pelvis. The procedure typically involves direct exposure of the fracture site with internal fixation using plates, screws, or similar devices to achieve reduction and stabilization.
Service Type: Surgical — Orthopedic open operative fixation of pelvic avulsion/iliac wing fracture
Typical Site of Service: Hospital inpatient or outpatient surgical suite, or ambulatory surgery center, depending on clinical severity and comorbidities.
Clinical & Coding Specifications
Clinical Context
A 28-year-old male presents after a high-energy motorcycle collision with severe left pelvic pain, inability to ambulate, and localized swelling over the iliac crest. Imaging (pelvic radiographs and CT) demonstrates an avulsion fracture of the left iliac crest with displacement involving the iliac wing and tuberosity. The orthopedic trauma surgeon evaluates the patient in the emergency department, obtains consent for surgery, and schedules an open reduction and internal fixation of the left iliac wing fracture under general anesthesia.
Preoperative workflow includes medical clearance, cross-sectional imaging review, and templating for plates and screws. In the operating room, the surgeon exposes the iliac crest fracture, performs open reduction, and secures fixation with contoured plates and cortical screws. Intraoperative fluoroscopy confirms reduction and hardware placement. Postoperative care includes pain control, DVT prophylaxis, wound checks, and weight-bearing instructions. Follow-up visits at 2 weeks and 6–12 weeks include radiographic assessment for fracture healing and hardware position.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
RT | Right side | Use when the procedure is performed on the right iliac wing/crest. |
LT | Left side | Use when the procedure is performed on the left iliac wing/crest. |
50 | Bilateral procedure | Use when open treatment of iliac fractures is performed on both sides during the same operative session. |
62 | Two surgeons | Use when two surgeons work together as primary surgeons performing distinct portions of the operation. |
79 | Unrelated procedure or service by the same physician during the postoperative period | Use when an unrelated procedure is performed during the global period for the iliac fixation. |
59 | Distinct procedural service | Use when another procedure performed at the same session is distinct and separately reportable (e.g., separate pelvic ring fixation). |
52 | Reduced services | Use when the procedure is partially reduced or not completed as planned (e.g., limited exposure without fixation). |
53 | Discontinued procedure | Use when the procedure is started but stopped for patient safety reasons before definitive fixation. |
22 | Increased procedural services | Use when work, time, and/or complexity substantially exceed typical for the procedure (must be documented). |
24 | Unrelated E/M during global period | Use when an unrelated evaluation and management service is provided during the global period (not in provided modifier list but commonly relevant). |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
| 207L00000X | Orthopaedic Surgery | Trauma and fracture fixation of pelvic ring and iliac wing. |
| 207X00000X | General Surgery | May perform pelvic fixation in certain trauma settings. |
| 290000000X | Emergency Medicine | Initial evaluation and stabilization prior to operative fixation. |
| 208U00000X | Pediatric Orthopedic Surgery | Pediatric iliac avulsion fixation when applicable. |
| 208000000X | Anesthesiology | Provides general anesthesia for the open fixation procedure. |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
S32.85 | Fracture of iliac crest | Directly describes iliac crest or wing fractures treated with open fixation. |
S32.82 | Avulsion fracture of pelvic bone | Covers tuberosity avulsions of the iliac spine/tuberosity requiring surgical repair. |
S32.89 | Other fracture of pelvis | Used for pelvic fractures of the iliac wing not otherwise specified. |
S32.3 | Fracture of sacrum | May be coded when associated sacral injury occurs with iliac fractures. |
S32.4 | Fracture of coccyx | Included when coccygeal injury is present alongside iliac fractures. |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
27215 | Open treatment of iliac spine, tuberosity avulsion, or iliac wing fractures, with internal fixation, when performed, pelvis; unilateral | Primary procedure for open reduction and internal fixation of an iliac wing/crest fracture on one side. |
73502 | Radiologic examination, knee, single view; this code is an example — Data not available in the input. | Data not available in the input. |
76000 | Fluoroscopic guidance; limited (e.g., single image) — this code is an example — Data not available in the input. | Data not available in the input. |
99024 | Postoperative follow-up visit global period usually included — this code is an example — Data not available in the input. | Data not available in the input. |