CPT code 27245 denotes open surgical treatment of femoral shaft fractures between, around, or below the trochanters using an intramedullary implant, often with interlocking screws or cerclage. This procedure is a common orthopedic intervention for stabilizing unstable femoral fractures and has significant implications for hospital surgical services, device utilization, and perioperative care nationally. It is typically performed in hospital operating rooms or ambulatory surgery centers depending on patient acuity.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise policy and billing overview, clinical context for when the procedure is appropriate, common payer coverage patterns, and coding considerations that affect claim adjudication. The publication highlights typical service settings, procedural components inherent to the code description, and common modifiers used in practice (input list provided). Where payer-specific benchmarks or policies are available, the report summarizes contrasts among major commercial insurers and Medicare to aid revenue cycle and compliance teams.

This summary is intended for clinical coders, orthopedic surgery administrators, and revenue cycle professionals seeking a national perspective on coding, billing, and operational issues tied to CPT code 27245. Data not available in the input will be identified as such in the detailed sections.