Summary & Overview

CPT 27259: Open Surgical Hip Reduction with Femoral Shortening

CPT code 27259 documents an open surgical procedure for treatment of spontaneous hip dislocation, involving incision, relocation of the femoral head, and shortening of the femoral shaft. This procedure is clinically significant for congenital hip instability and disease-related dislocations that do not reduce with closed methods, and it impacts surgical specialty billing, resource allocation, and inpatient surgical case mix nationally. Key payers considered in this national overview include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.

Readers will find a compact briefing on clinical intent and typical service settings for 27259, plus a synthesis of payer coverage considerations and common billing modifiers. The publication highlights benchmark billing practices and coding nuances that affect reimbursement and claims processing for open hip reduction with femoral shortening. It also outlines where to look for related codes and clinical documentation needs. Data not available in the input for specific payer policies, associated taxonomies, and ICD-10 pairings is noted where applicable. This summary aims to orient coding specialists, surgical teams, and policy analysts to the clinical and billing context of CPT code 27259 at a national level.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare27259CPThip surgeryopen reductionfemoral shorteningorthopedic surgerysurgical billingoperative procedureinpatient surgery

Billing Code Overview

CPT code 27259 describes an open surgical procedure to treat a spontaneous dislocation of the hip. The surgeon makes an incision in the hip, repositions the femoral head into the acetabulum, and performs shortening of the femoral shaft as part of the corrective procedure.

Service type: Open surgical hip reduction with femoral shortening
Typical site of service: Inpatient or outpatient surgical setting (operating room) depending on clinical severity and patient needs

Data not available in the input.

Clinical & Coding Specifications

Clinical Context

A 6-year-old child presents with chronic hip instability and a history of developmental dysplasia of the hip (DDH) with recurrent spontaneous dislocations of the hip despite conservative management. After clinical evaluation and imaging (anteroposterior and frog‑leg lateral pelvis radiographs, and an MRI to assess cartilaginous structures), the orthopedic surgeon schedules an open reduction with femoral shortening osteotomy to reposition the femoral head into the acetabulum and shorten the femoral shaft to relieve tension on the reduced hip. The preoperative workflow includes anesthesia evaluation, informed consent, surgical site marking, and templating for osteotomy and fixation. Intraoperatively, under general anesthesia and with fluoroscopic guidance, a surgical incision is made over the hip, the femoral head is reduced into the acetabulum, a segmental femoral shortening osteotomy is performed, and internal fixation (plate and screws or intramedullary device) stabilizes the femur. Postoperative care includes pain control, neurovascular checks, prophylactic antibiotics as indicated, hip spica casting or protected weight bearing per fixation method, and scheduled follow‑up radiographs to confirm maintained reduction and osteotomy healing.

Coding Specifications

Modifier	Description	When to Use
`00`	Default — no modifier	Use when no special modifier applies; some payors recognize as technical placeholder.
`11`	Professional Component	Use when reporting only the surgeon’s professional component separate from facility billing if required by payor.
`22`	Increased Procedural Services	Use when work, time, and complexity substantially exceed typical for the procedure (document justification).
`52`	Reduced Services	Use when the procedure is partially reduced or not completed as planned (document extent).
`53`	Discontinued Procedure	Use when procedure is started but terminated due to extenuating circumstances prior to completion.
`62`	Two Surgeons	Use when two surgeons with distinct skills are required and both perform part of the procedure.
`63`	Procedure Performed on Infants and Children	Use when the service is performed on neonates/infants where payor requires age-specific modifier (note: verify payor policy).
`66`	Surgical Team (Team Surgery)	Use when a team approach is documented and payor recognizes team modifier for major complex cases.
`80`	Assistant Surgeon	Use when an assistant surgeon performs part of the operation and documentation supports assistant role.
`62`	Two Surgeons	Use when two surgeons with different specialties both perform substantial portions of the procedure.
`LT`	Left side	Use to indicate the left hip was operated on.
`RT`	Right side	Use to indicate the right hip was operated on.

Taxonomy Code	Specialty	Notes
`207X00000X`	Orthopaedic Surgery	Primary specialty performing open hip reduction and femoral shortening osteotomy.
`2080P0207X`	Pediatric Orthopedic Surgery	Subspecialty for pediatric cases such as DDH with surgical reconstruction.
`207K00000X`	Orthopedic Trauma	Manages complex hip instability when related to traumatic deformity or reconstruction.
`2086S0122X`	Pediatric Surgery	May be involved in multidisciplinary pediatric perioperative care.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`Q65.0`	Congenital dislocation of hip, unilateral	Common cause of spontaneous hip dislocation from birth requiring surgical reduction and femoral shortening.
`Q65.2`	Congenital subluxation of hip	Represents instability that may progress to recurrent dislocation and need for operative correction.
`M16.11`	Unilateral primary osteoarthritis of hip, right	Degenerative causes can contribute to hip instability in older patients; not typical for pediatric DDH but relevant in adults with recurrent dislocation.
`M24.35`	Recurrent dislocation, hip	Directly indicates recurrent dislocation as the clinical indication for open reduction and femoral shortening.
`M21.65`	Contracture of hip	Soft tissue contractures often accompany chronic dislocation and may necessitate femoral shortening to allow reduction.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`27259`	Open treatment of recurrent dislocation of hip; with femoral shortening and/or osteotomy, with or without acetabular procedure	Primary procedure coded for open reduction with femoral shortening in recurrent hip dislocation.
`27146`	Reconstruction, acetabular; with graft (e.g., for dysplasia)	May be performed concurrently if acetabular reconstruction is required to improve coverage of the femoral head.
`27220`	Open treatment of femoral neck fracture, proximal femur procedures	Used when proximal femoral osteotomy or fixation techniques overlap with femoral procedures during the case.
`20690`	Application of external fixation device (unlisted application)	May be used if external fixation is applied postoperatively for stability in select cases.
`27758`	Osteotomy, femoral; intertrochanteric, with internal fixation	Alternative or adjunct femoral osteotomy code when procedure approach matches intertrochanteric osteotomy with fixation.