Summary & Overview

CPT 27217: Open Treatment of Anterior Pelvic Ring Fracture

CPT code 27217 covers open surgical treatment of anterior pelvic ring fractures or dislocations on one side of the pelvis, frequently involving internal fixation with plates and screws. This code is used for definitive operative management when the fracture pattern disrupts the pelvic ring and requires reduction and stabilization. Nationally, the code is relevant because pelvic ring injuries carry high morbidity, often require operative care in inpatient settings, and drive hospital resource use including operating room time, implants, and postoperative inpatient care.

Key payers in the national landscape include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of clinical context for the procedure, typical sites of service, common modifiers and billing considerations, and how the code maps to surgical service lines. The publication also summarizes payer coverage patterns and benchmarking where available and highlights policy and coding nuances that affect claim adjudication and hospital billing workflows.

This piece is intended to help coding professionals, revenue leaders, and policy analysts understand the clinical intent of CPT code 27217, the operational setting in which it is billed, and the main areas to review during claims submission and reimbursement reconciliation. Data not available in the input will be noted where applicable.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareCPT 27217pelvic fracture fixationorthopedic surgeryinpatient surgeryopen reduction internal fixationbilling and codingsurgical implantspelvic ring injury

Billing Code Overview

CPT code 27217 describes an open treatment of an anterior pelvic ring fracture or dislocation on one side of the pelvis, typically involving reduction and internal fixation. The procedure commonly includes the use of internal fixation implants such as plates and screws to stabilize fracture patterns that disrupt the pelvic ring.

Service Type: Open orthopedic surgery — pelvic fracture fixation

Typical Site of Service: Hospital operating room or inpatient surgical center

Clinical & Coding Specifications

Clinical Context

A 42-year-old male is brought to the emergency department after a high-energy motor vehicle collision with pelvic pain, hemodynamic stability, and pelvic ring instability on imaging. CT and pelvic radiographs demonstrate an anterior pelvic ring fracture involving the pubic rami with displacement and disruption of the unilateral pelvic ring. After initial resuscitation, the orthopedic trauma team evaluates the patient and determines the fracture requires open reduction and internal fixation. The patient is scheduled for operative treatment under general anesthesia. In the operating room, the orthopedic surgeon performs an open anterior pelvic fixation procedure using plates and screws to reduce and stabilize the disrupted anterior pelvic ring on one side. Intraoperative imaging (fluoroscopy) is used to confirm reduction and hardware placement. Postoperatively, the patient is monitored on a trauma or orthopedic inpatient unit for pain control, neurovascular checks, venous thromboembolism prophylaxis, and weight-bearing instruction. Follow-up includes outpatient clinic visits with radiographs to assess healing and hardware position.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	Use when work, time, or complexity of `27217` is substantially greater than typical due to scarring, infection, or complex anatomy.
`23`	Unusual anesthesia	Use when `27217` is performed with general or regional anesthesia that is medically contraindicated but necessary due to extenuating circumstances.
`50`	Bilateral procedure	Use when identical anterior pelvic ring procedures are performed on both sides during the same operative session.
`51`	Multiple procedures	Use when `27217` is one of multiple distinct procedures performed during the same operative session (report per payer rules).
`52`	Reduced services	Use when `27217` is partially reduced or not completed as planned.
`53`	Discontinued procedure	Use when `27217` is started but terminated due to extenuating circumstances before completion.
`58`	Staged or related procedure by the same physician during the postoperative period	Use when `27217` is planned as a staged procedure following an initial temporary fixation.
`62`	Two surgeons	Use when two surgeons work together as primary surgeons for `27217` (co-surgery).
`76`	Repeat procedure by same physician	Use when `27217` is repeated later the same day by the same physician (note: `76` not in provided list — excluded).
`78`	Unplanned return to the OR by the same physician following initial procedure for a related procedure during the postoperative period	Use when a return to OR is required for revision or complication after `27217`.
`79`	Unrelated procedure by the same physician during the postoperative period	Use when an unrelated procedure is performed after `27217` during the global period.
`LT`	Left side	Use to indicate `27217` was performed on the left side of the pelvis.
`RT`	Right side	Use to indicate `27217` was performed on the right side of the pelvis.
`GB`	Not in provided list — excluded	Data not available in the input.

Taxonomy Code	Specialty	Notes
207X00000X	Orthopaedic Surgery	Primary specialty performing open pelvic fracture fixation including `27217`.
2080S0122X	Orthopedic Trauma Surgery	Subspecialty focus on complex pelvic and acetabular fractures.
207L00000X	Surgery, General (Trauma)	Trauma surgeons may perform pelvic stabilization in combined multidisciplinary care.
207K00000X	Surgery, Surgery of the Hand — Not applicable	Data not available in the input.
363L00000X	Emergency Medicine	Emergency physicians provide initial stabilization and coordination prior to operative fixation.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`S32.421A`	Displaced fracture of right pubis, initial encounter for closed fracture	Pubic rami fractures disrupting the anterior pelvic ring commonly indicate need for open fixation with `27217`.
`S32.422A`	Displaced fracture of left pubis, initial encounter for closed fracture	Left-sided anterior pelvic ring disruption treated with open reduction and internal fixation using `27217`.
`S32.43XA`	Fracture of pubic symphysis, initial encounter for closed fracture	Symphyseal disruption is an anterior ring injury commonly addressed with open fixation as coded by `27217`.
`S32.451A`	Fracture of superior pubic ramus, right side, initial encounter for closed fracture	Superior pubic ramus fractures that destabilize the pelvic ring may require `27217`.
`S32.452A`	Fracture of superior pubic ramus, left side, initial encounter for closed fracture	Left-sided superior pubic ramus fractures with displacement are indications for open anterior pelvic fixation.
`S32.439A`	Other fracture of pubis, initial encounter for closed fracture	Other pubic fractures causing anterior pelvic ring instability may be treated with `27217`.
`S32.49XA`	Multiple fractures of pelvis, initial encounter for closed fracture	Complex pelvic ring injuries involving multiple pelvic components often require combined anterior and posterior fixation including `27217`.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`27220`	Open treatment of posterior pelvic ring disruption (ileum, sacroiliac joint or sacrum) with internal fixation	Often performed alongside `27217` when both anterior and posterior pelvic ring injuries require fixation for ring stability.
`27235`	Open treatment of acetabular fracture, posterior wall and/or posterior column with internal fixation	May be required if acetabular involvement is present with the anterior pelvic fracture, addressing articular surface injury.
`23470`	Open treatment of fracture, humerus; with internal fixation — (example unrelated upper extremity code)	Data not available in the input.
`20680`	Removal of implanted deep fixation device, requiring open approach	May be performed weeks to months later if hardware removal from `27217` is indicated for pain or infection.
`76000`	Fluoroscopic guidance; image intensifier, first radiographic image	Used intraoperatively to guide reduction and hardware placement during `27217`.
`99223`	Initial hospital care, typically 70 minutes or more	Typical initial inpatient evaluation for an adult with pelvic fracture requiring operative fixation.