Summary & Overview
CPT 27279: Unilateral Percutaneous Sacroiliac Joint Fusion
Headline: CPT code 27279: Unilateral percutaneous sacroiliac joint fusion with transarticular or intra‑articular implants
CPT code 27279 denotes a unilateral sacroiliac (SI) joint fusion performed via a percutaneous or minimally invasive approach, where implants traverse the joint and pierce cortical bone of the ilium and sacrum or involve intra‑articular devices with at least one cortical breach. The code matters nationally as utilization of minimally invasive SI joint fusion has grown with advances in implant technology and expanding indications for surgical management of SI joint dysfunction and pain.
This analysis covers major national payers: Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the clinical service represented by the code, typical sites of service, and the payer landscape. The publication summarizes how the code is reported on claims and what elements define the billed service. It also outlines common modifiers associated with operative billing and highlights areas where policy language or coverage criteria commonly affect payment and prior authorization practice.
Intended readers will gain a clear operational understanding of CPT code 27279, including clinical context, billing considerations, and the payer mix addressed in this national overview.
Billing Code Overview
CPT code 27279 describes a sacroiliac (SI) joint fusion performed using a percutaneous or minimally invasive approach. The procedure involves placement of transarticular implants that cross the SI joint and pierce the cortical bone of the ilium and sacrum, and/or intra‑articular implants with at least one implant piercing cortical bone. This code represents a unilateral SI joint fusion (one side only).
Service type: Minimally invasive surgical spine/pelvic procedure
Typical site of service: Hospital outpatient surgical department or ambulatory surgery center, reflecting a percutaneous/minimally invasive operative setting.
Clinical & Coding Specifications
Clinical Context
A 52-year-old patient presents with chronic unilateral sacroiliac (SI) joint pain refractory to conservative care including physical therapy, activity modification, NSAIDs, and image-guided SI joint injections. Pain is localized to the posterior superior iliac region, reproduces with provocative SI maneuvers, and diagnostic SI joint block provided significant temporary relief. After multidisciplinary evaluation and imaging (CT and/or MRI showing degenerative changes or joint disruption), the patient is scheduled for a unilateral minimally invasive sacroiliac joint fusion using percutaneous transarticular and/or intra-articular implants (CPT 27279).
The typical clinical workflow includes preoperative evaluation and optimization, informed consent discussing risks/benefits and implant specifics, preoperative imaging review, intraoperative fluoroscopic or CT guidance for implant placement across the joint with cortical bone purchase of ilium and sacrum, intraoperative neuromonitoring as indicated, wound closure and recovery in an ambulatory surgery center or hospital outpatient setting, and postoperative pain control with staged rehabilitation. Follow-up includes wound check, radiographic confirmation of hardware position, progressive activity advancement, and monitoring for union and symptom improvement.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
62 | Two surgeons | Used when two surgeons perform distinct portions of the operative procedure requiring documentation of separate surgical work for . |