Summary & Overview
CPT 27218: Open Treatment of Posterior Pelvic Ring Fracture
CPT code 27218 denotes open treatment of a posterior pelvic ring fracture or dislocation with internal fixation on one side of the pelvis. This procedure is a key surgical intervention for pelvic ring disruptions that compromise stability, mobility, and the ability to bear weight. Nationally, accurate coding for these complex orthopedic procedures affects hospital billing, resource allocation, and quality measurement for trauma and orthopedic services.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical context for the procedure, typical sites of service, and the service type. The publication also summarizes common billing considerations, commonly reported modifiers, and where CPT code 27218 fits within surgical and trauma care pathways.
This overview prepares clinical, billing, and policy audiences to understand benchmark interpretations, payer coverage patterns, and policy updates that influence authorization and claim adjudication for open pelvic fixation procedures. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 27218 describes an open treatment of a posterior pelvic ring disruption on one side of the pelvis. The procedure involves surgical exposure of the posterior pelvic bone and may include internal fixation using devices such as plates and screws to restore pelvic ring stability.
Service type: Open surgical fixation of posterior pelvic ring fracture or dislocation
Typical site of service: Inpatient hospital or ambulatory surgery center (operating room)
Clinical & Coding Specifications
Clinical Context
A 42-year-old male motorcyclist presents to the emergency department after a high-energy collision with pelvic pain, instability, and inability to bear weight. Imaging (pelvic radiographs and CT) demonstrates a displaced posterior pelvic ring fracture through the ilium and sacroiliac region with disruption of the pelvic ring on one side. The patient is hemodynamically stable after resuscitation and is scheduled for operative management.
Preoperative workflow includes trauma evaluation, surgical consent, cross-sectional imaging review, and coordination with anesthesia and blood bank. In the operating room, the orthopedic trauma or pelvic reconstruction surgeon performs an open reduction and internal fixation of the posterior pelvic ring fracture using plates and screws (and possible supplemental sacroiliac screws). Intraoperative fluoroscopy confirms reduction and hardware placement. Postoperative care includes pain control, DVT prophylaxis, mobility planning with physical therapy, and follow-up radiographs to confirm continued alignment and healing. Typical hospitalization ranges from short observation to several days depending on concomitant injuries and recovery.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
LT | Left side | When the procedure is performed on the left pelvis/hip region |