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    OpenPayerBilling CodesFracture and/or Dislocation Procedures on the Pelvis and Hip JointCPT cpt-27218-open-treatment-posterior-pelvic-ring-fracture-fixation
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    CPT 27218: Open Treatment of Posterior Pelvic Fracture

    CPT code 27218 describes open surgical treatment of a posterior pelvic fracture or pelvic ring disruption on one side, typically involving internal fixation such as plates and screws; this procedure is an open pelvic fracture repair and is classified as an orthopedic surgical service performed in an operating room setting, often at an inpatient hospital or ambulatory surgery center when clinically appropriate.

    For related coverage guidance, see recent payer policy updates: Orthopedic Joint Procedures of the Knee for Managed Medicaid (MMC), Health and Recovery Plan (HARP), Child Health Plus (CHP), and Essential Plan (EP) Members, Autologous Chondrocyte Transplantation or Implantation Corporate Medical Policy, Autologous Platelet-Derived Growth Factors (Platelet-Rich Plasma [PRP]).

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    Table of contents

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    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.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    72192Computed tomography, pelvis; without contrastPreoperative cross-sectional imaging to characterize pelvic fracture patterns and surgical planning
    73502Radiologic examination, hip, centers on two views; unilateralInitial radiographs of the pelvis/hip to identify fracture and guide urgency of fixation
    27096Percutaneous skeletal fixation of pelvic ring fracture (e.g., iliosacral screw), with image guidanceMay be performed as an alternative or adjunct to open fixation for select posterior pelvic ring injuries
    20680Removal of deep implant; requiring major incision and/or complicated exposurePossible later procedure for removal of plates or screws if hardware becomes symptomatic or infected
    99024Postoperative follow-up visit, typical global period (hospital)Represents routine postoperative hospital follow-up care during the global surgical package

    Related Modifiers

    12 rows

    ModifierDescriptionWhen to Use
    50Modifier –50 (Bilateral Procedure) is appended to a CPT code when an identical procedure is performed on paired anatomical structures during the same operative session. The AMA states to add…- Use modifier -50 when the same CPT surgical, diagnostic, or radiology procedure is performed on paired anatomical structures (both sides of the body) during the same operative/session by the same…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    80CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…
    81Modifier -81 indicates a physician served as a minimal assistant surgeon for part—not all—of an operative procedure. Use when a physician’s assisting role is limited and does not represent full…- Use CPT modifier -81 when a physician acts as a minimum assistant surgeon who assists during only part (a limited portion) of an operative procedure; append -81 to the primary surgical CPT code to…
    82Modifier 82 is appended to a surgical CPT code to indicate that an attending physician acted as an assistant because a qualified resident surgeon was unavailable. In teaching hospitals it documents…- When to use: Append modifier 82 in teaching-hospital settings to indicate a physician served as an assistant surgeon because a qualified resident surgeon was unavailable (includes situations where…
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
    79Modifier 79 indicates a surgical procedure performed during the postoperative global period of a prior surgery that is unrelated to the original procedure. Per AMA/CPT and CMS guidance, it is…- Use modifier 79 when the same physician (or same‑specialty physician in the same group) performs a surgical procedure during the postoperative global period of a prior surgery and the new procedure…

    Showing 1–10 of 12

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    207L00000X
    208VP0000X
    213E00000X
    103TA0700X
    207RM1200X
    246YC3301X
    2085R0203X
    242T00000X

    Related ICD-10-CM Codes

    14 rows

    ICD-10-CM CodeDescription
    S32.10XAUnspecified fracture of sacrum, initial encounter for closed fracture
    S32.401AUnspecified fracture of right acetabulum, initial encounter for closed fracture
    S32.402AUnspecified fracture of left acetabulum, initial encounter for closed fracture
    S32.411ADisplaced fracture of anterior wall of right acetabulum, initial encounter for closed fracture
    S32.412ADisplaced fracture of anterior wall of left acetabulum, initial encounter for closed fracture
    S32.413ADisplaced fracture of anterior wall of unspecified acetabulum, initial encounter for closed fracture
    S32.431ADisplaced fracture of anterior column [iliopubic] of right acetabulum, initial encounter for closed fracture
    S32.432ADisplaced fracture of anterior column [iliopubic] of left acetabulum, initial encounter for closed fracture
    S32.433ADisplaced fracture of anterior column [iliopubic] of unspecified acetabulum, initial encounter for closed fracture
    S32.451ADisplaced transverse fracture of right acetabulum, initial encounter for closed fracture

    Showing 1–10 of 14

    Related Payer Policy Updates

    Specialty: Orthopedics/Musculoskeletal1 / 2

    10 rows

    PolicyPayerEffective Date
    Orthopedic Joint Procedures of the Knee for Managed Medicaid (MMC), Health and Recovery Plan (HARP), Child Health Plus (CHP), and Essential Plan (EP) Membersuniverahealthcare2027-01-01
    Autologous Chondrocyte Transplantation or Implantation Corporate Medical Policybcbsvermont2026-12-01
    Autologous Platelet-Derived Growth Factors (Platelet-Rich Plasma [PRP])Cigna2026-10-15
    Metatarsophalangeal Joint ReplacementCigna2026-10-15
    Shoulder Arthroplasty (Total, Partial, Reverse, Revision and Resurfacing)univerahealthcare2026-10-15
    Hip Arthroplasty (partial and total hip replacement)univerahealthcare2026-10-15
    Artificial Lumbar Intervertebral Disc (Lumbar Total Disc Arthroplasty)univerahealthcare2026-10-15
    Osteochondral Grafting of the Kneeuniverahealthcare2026-10-15
    Lumbar Fusion (arthrodesis) with decompressionuniverahealthcare2026-10-15
    Metal-on-Metal Total Hip Resurfacinguniverahealthcare2026-10-15

    Related Codes

    CPT-27197-POSTERIOR-PELVIC-FRACTURE-TREATMENT-NO-MANIPULATION

    CPT 27197: Treatment of Posterior Pelvic Ring Separation Without Manipulation

    CPT-27198-PELVIC-RING-MANIPULATION-UNDER-ANESTHESIA

    CPT 27198: Manipulation of Posterior Pelvic Ring Fracture

    CPT-27200-CLOSED-TREATMENT-COCCYX-FRACTURE

    CPT 27200: Closed Treatment of Coccyx (Tailbone) Fracture

    CPT-27202-OPEN-TREATMENT-COCCYX-FRACTURE-WITH-FIXATION

    CPT 27202: Open Treatment of Coccyx Fracture

    CPT-27215-ILIAC-SPINE-TUBEROSITY-AVULSION-ILIAC-WING-FIXATION

    CPT 27215: Open Treatment of Iliac Spine/Tuberosity Avulsion or Iliac Wing Fracture

    CPT-27216-PELVIC-EXTERNAL-FIXATION-FOR-PELVIC-RING-INJURY

    CPT 27216: Unilateral Pelvic External Fixation

    CPT-27217-OPEN-TREATMENT-ANTERIOR-PELVIC-RING-FRACTURE-FIXATION

    CPT 27217: Open Treatment of Anterior Pelvic Ring Fracture

    CPT-27220-CLOSED-TREATMENT-ACETABULAR-FRACTURE

    CPT 27220: Closed Treatment of Acetabular (Hip Socket) Fracture

    CPT-27222-CLOSED-TREATMENT-ACETABULAR-FRACTURE

    CPT 27222: Closed Treatment of Acetabular (Hip Socket) Fracture

    CPT-27226-ACETABULAR-WALL-FRACTURE-OPEN-FIXATION

    CPT 27226: Open Fixation of Acetabular Wall Fracture

    Showing 1–10 of 35

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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