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CPT 27282: Pubic Symphysis Arthrodesis with Autologous Bone Graft and Fixation

CPT code 27282 identifies surgical arthrodesis of the pubic symphysis with internal fixation and autologous bone grafting. Nationally, this procedure is used to achieve durable stabilization of the anterior pelvic ring in patients with symptomatic instability, nonunion, or traumatic disruption of the symphysis pubis. Accurate coding for this procedure matters for hospital and surgical reimbursement, care coordination, and tracking utilization of advanced pelvic reconstruction techniques.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context for CPT code 27282, the typical sites of service, and the types of surgical services represented. The publication provides benchmarks and comparative payer coverage notes where available, summarizes relevant policy considerations affecting authorization and facility setting, and outlines clinical and coding context to support correct claim submission. Data not available in the input is noted where applicable.

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Billing Code Overview

CPT code 27282 describes a surgical procedure to arthrodese (immobilize) the symphysis pubis joint of the pelvis using fixation devices and an autologous bone graft to induce bone formation at the joint site. The procedure involves open surgical access to the pubic symphysis, placement of internal fixation hardware, and harvesting and placement of the patient's own bone graft to promote fusion.

Service type: Surgical orthopedic procedure — pelvic fusion/arthrodesis
Typical site of service: Inpatient or outpatient hospital operating room or ambulatory surgery center, depending on patient condition and procedural complexity

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CPT 27282: Pubic Symphysis Arthrodesis with Autologous Bone Graft and Fixation

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Billing Code Overview

Service type: Surgical orthopedic procedure — pelvic fusion/arthrodesis
Typical site of service: Inpatient or outpatient hospital operating room or ambulatory surgery center, depending on patient condition and procedural complexity

Clinical & Coding Specifications

Clinical Context

A typical patient is a 35–55-year-old adult with symptomatic pubic symphysis diastasis or chronic pubic symphysis instability following trauma, childbirth-related pubic separation, or failed conservative management for osteitis pubis. The patient experiences persistent suprapubic pain, gait disturbance, and difficulty with activities that load the pelvis despite physical therapy, analgesics, and pelvic binders. Imaging (X-ray, CT, or MRI) demonstrates widening, chronic instability, or degenerative change of the pubic symphysis.

The clinical workflow: preoperative evaluation includes history, focused pelvic exam, review of imaging, medical clearance, and informed consent discussing autograft harvest. Operative steps typically involve general or regional anesthesia, exposure of the pubic symphysis, debridement of the joint, placement of internal fixation (plates, screws, or symphyseal fixation devices) to achieve reduction and stabilization, and placement of an autologous bone graft harvested from the iliac crest to induce fusion. Intraoperative imaging confirms alignment. Postoperative care includes pain control, limited weight-bearing, physical therapy progression, and follow-up imaging to document fusion and hardware position. Hospital inpatient or outpatient surgical center settings are typical depending on patient comorbidities and procedure complexity.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	Use when documentation supports substantially greater work than typical for the procedure (extensive debridement, prolonged operative time).
`23`	Unusual anesthesia	Use when general anesthesia is contraindicated and an unusual anesthesia circumstance is documented.
`62`	Two surgeons	Use when two surgeons from different specialties perform distinct surgical segments and documentation supports shared responsibility.
`63`	Procedure performed on infants less than 4 kg	Not typically used for adults; include only if performed on qualifying infant.
`66`	Surgical team (more than one physician)	Use when a surgical team approach is documented (complex pelvic reconstruction).
`78`	Return to the operating room for a related procedure during the postoperative period	Use if patient returns to OR for a complication related to the index symphysis fusion.
`79`	Unrelated procedure or service by the same physician during the postoperative period	Use if an unrelated procedure is performed during the global period.
`80`	Assistant surgeon	Use when an assistant surgeon is documented and paid separately.
`81`	Minimum assistant surgeon	Use when a minimum assistant is used and documentation supports reduced assistant involvement.
`50`	Bilateral procedure	Use if both pubic rami/symphysis procedures are reported and payer accepts bilateral modifier for pelvic procedures.
`51`	Multiple procedures	Use when additional distinct procedures are performed at the same operative session (e.g., pelvic fixation plus separate abdominal procedure).
`52`	Reduced services	Use when the procedure is partially reduced or not completed as planned.
`53`	Discontinued procedure	Use when the procedure is terminated after initiation for reasons outside the control of the physician.
`76`	Repeat procedure by same physician	(Not in provided list) Data not available in the input.

Taxonomy Code	Specialty	Notes
`208000000X`	Orthopaedic Surgery	Primary specialty performing pelvic ring stabilization and symphysis fusion.
`208U00000X`	Orthopaedic Trauma	Subspecialty for complex traumatic pubic symphysis injuries requiring fixation.
`2084P0800X`	Surgery of the Pelvis and Perineum (Urology/General Surgery overlap)	Used when multidisciplinary pelvic surgery is required; assists with exposure or concurrent procedures.
`207L00000X`	Obstetrics & Gynecology	May be involved when pubic symphysis disruption is childbirth-related and consultation or combined approach is needed.
`206E00000X`	Physical Medicine & Rehabilitation	Involved pre- and postoperatively for functional recovery planning.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`S33.5X0A`	Sprain of pubic symphysis, initial encounter	Represents acute traumatic disruption or sprain of the pubic symphysis that may progress to instability requiring surgical fixation and fusion.
`S32.89XA`	Other fracture of pelvis, initial encounter	Pelvic fractures involving the pubic symphysis can necessitate open reduction and internal fixation with grafting for stabilization.
`M79.1`	Myalgia	May reflect chronic pelvic pain associated with symphyseal dysfunction; supportive diagnosis in the preoperative assessment.
`M36.11`	Osteitis pubis	Inflammatory condition of the pubic symphysis that can become chronic and refractory to conservative care, leading to surgical fusion.
`O71.8XX0`	Other obstetric trauma to pelvic organs, initial encounter	Childbirth-related pubic symphysis separation or instability may require surgical stabilization and arthrodesis.
`N99.9`	Postprocedural disorder of genitourinary system, unspecified	Relevant for postoperative complications involving pelvic structures that may prompt revision or additional procedures.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`27280`	Open treatment of pelvic ring disruption, anterior posterior compression (eg, open reduction internal fixation of pubic symphysis)	Often used for open reduction and internal fixation of pubic symphysis without grafting; may be reported if fixation is performed without arthrodesis.
`20937`	Structural bone graft, spine; thoracic, lumbar, sacral (includes obtaining graft)	Used when an autologous structural graft is harvested and used to provide stability—codes for graft work when applicable.
`20930`	Allograft, morselized, or placement of bone graft substitute	May be reported when bone graft substitute or allograft is used instead of autograft.
`20936`	Autograft for spine surgery only (harvest of bone graft)	Related when autograft harvest from iliac crest is billed separately; technique and site determine appropriate graft-harvest code.
`20680`	Removal of implant; deep (e.g., plate, screw)	May be reported if hardware removal is performed in a staged or subsequent procedure due to pain, infection, or mechanical failure.
`76000`	Fluoroscopy, surgical guidance (intraoperative)	Used to report intraoperative imaging guidance when fluoroscopy is required for implant placement and reduction confirmation.

CPT 27278: Unilateral Minimally Invasive Sacroiliac Joint Fusion

CPT-27279-SACROILIAC-JOINT-FUSION-PERCUTANEOUS-UNILATERAL

CPT 27279: Unilateral Percutaneous Sacroiliac Joint Fusion

CPT-27280-SACROILIAC-JOINT-FUSION-OPEN-WITH-AUTOGRAFT

CPT 27280: Open Sacroiliac Joint Fusion with Autograft and Instrumentation

CPT-27284-HIP-ARTHRODESIS-WITH-AUTOGRAFT

CPT 27284: Hip Arthrodesis with Autologous Bone Graft

CPT-27286-HIP-IMMOBILIZATION-WITH-GRAFT-AND-SUBTROCHANTERIC-OSTEOTOMY

CPT 27286: Hip Immobilization with Autologous Bone Graft and Osteotomy

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Jul 29, 2026.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.

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Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	Use when documentation supports substantially greater work than typical for the procedure (extensive debridement, prolonged operative time).
`23`	Unusual anesthesia	Use when general anesthesia is contraindicated and an unusual anesthesia circumstance is documented.
`62`	Two surgeons	Use when two surgeons from different specialties perform distinct surgical segments and documentation supports shared responsibility.
`63`	Procedure performed on infants less than 4 kg	Not typically used for adults; include only if performed on qualifying infant.
`66`	Surgical team (more than one physician)	Use when a surgical team approach is documented (complex pelvic reconstruction).
`78`	Return to the operating room for a related procedure during the postoperative period	Use if patient returns to OR for a complication related to the index symphysis fusion.
`79`	Unrelated procedure or service by the same physician during the postoperative period	Use if an unrelated procedure is performed during the global period.
`80`	Assistant surgeon	Use when an assistant surgeon is documented and paid separately.
`81`	Minimum assistant surgeon	Use when a minimum assistant is used and documentation supports reduced assistant involvement.
`50`	Bilateral procedure	Use if both pubic rami/symphysis procedures are reported and payer accepts bilateral modifier for pelvic procedures.
`51`	Multiple procedures	Use when additional distinct procedures are performed at the same operative session (e.g., pelvic fixation plus separate abdominal procedure).
`52`	Reduced services	Use when the procedure is partially reduced or not completed as planned.
`53`	Discontinued procedure	Use when the procedure is terminated after initiation for reasons outside the control of the physician.
`76`	Repeat procedure by same physician	(Not in provided list) Data not available in the input.

Taxonomy Code	Specialty	Notes
`208000000X`	Orthopaedic Surgery	Primary specialty performing pelvic ring stabilization and symphysis fusion.
`208U00000X`	Orthopaedic Trauma	Subspecialty for complex traumatic pubic symphysis injuries requiring fixation.
`2084P0800X`	Surgery of the Pelvis and Perineum (Urology/General Surgery overlap)	Used when multidisciplinary pelvic surgery is required; assists with exposure or concurrent procedures.
`207L00000X`	Obstetrics & Gynecology	May be involved when pubic symphysis disruption is childbirth-related and consultation or combined approach is needed.
`206E00000X`	Physical Medicine & Rehabilitation	Involved pre- and postoperatively for functional recovery planning.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`S33.5X0A`	Sprain of pubic symphysis, initial encounter	Represents acute traumatic disruption or sprain of the pubic symphysis that may progress to instability requiring surgical fixation and fusion.
`S32.89XA`	Other fracture of pelvis, initial encounter	Pelvic fractures involving the pubic symphysis can necessitate open reduction and internal fixation with grafting for stabilization.
`M79.1`	Myalgia	May reflect chronic pelvic pain associated with symphyseal dysfunction; supportive diagnosis in the preoperative assessment.
`M36.11`	Osteitis pubis	Inflammatory condition of the pubic symphysis that can become chronic and refractory to conservative care, leading to surgical fusion.
`O71.8XX0`	Other obstetric trauma to pelvic organs, initial encounter	Childbirth-related pubic symphysis separation or instability may require surgical stabilization and arthrodesis.
`N99.9`	Postprocedural disorder of genitourinary system, unspecified	Relevant for postoperative complications involving pelvic structures that may prompt revision or additional procedures.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`27280`	Open treatment of pelvic ring disruption, anterior posterior compression (eg, open reduction internal fixation of pubic symphysis)	Often used for open reduction and internal fixation of pubic symphysis without grafting; may be reported if fixation is performed without arthrodesis.
`20937`	Structural bone graft, spine; thoracic, lumbar, sacral (includes obtaining graft)	Used when an autologous structural graft is harvested and used to provide stability—codes for graft work when applicable.
`20930`	Allograft, morselized, or placement of bone graft substitute	May be reported when bone graft substitute or allograft is used instead of autograft.
`20936`	Autograft for spine surgery only (harvest of bone graft)	Related when autograft harvest from iliac crest is billed separately; technique and site determine appropriate graft-harvest code.
`20680`	Removal of implant; deep (e.g., plate, screw)	May be reported if hardware removal is performed in a staged or subsequent procedure due to pain, infection, or mechanical failure.
`76000`	Fluoroscopy, surgical guidance (intraoperative)	Used to report intraoperative imaging guidance when fluoroscopy is required for implant placement and reduction confirmation.

CPT 27278: Unilateral Minimally Invasive Sacroiliac Joint Fusion

CPT-27279-SACROILIAC-JOINT-FUSION-PERCUTANEOUS-UNILATERAL

CPT 27279: Unilateral Percutaneous Sacroiliac Joint Fusion

CPT-27280-SACROILIAC-JOINT-FUSION-OPEN-WITH-AUTOGRAFT

CPT 27280: Open Sacroiliac Joint Fusion with Autograft and Instrumentation

CPT-27284-HIP-ARTHRODESIS-WITH-AUTOGRAFT

CPT 27284: Hip Arthrodesis with Autologous Bone Graft

CPT-27286-HIP-IMMOBILIZATION-WITH-GRAFT-AND-SUBTROCHANTERIC-OSTEOTOMY

CPT 27286: Hip Immobilization with Autologous Bone Graft and Osteotomy

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Jul 29, 2026.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.

Published by

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CPT 27282: Pubic Symphysis Arthrodesis with Autologous Bone Graft and Fixation

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Billing Code Overview

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Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References

CPT 27282: Pubic Symphysis Arthrodesis with Autologous Bone Graft and Fixation

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Billing Code Overview

CPT 27282: Pubic Symphysis Arthrodesis with Autologous Bone Graft and Fixation

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Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

What does CPT 27282 represent and where is this procedure typically performed?

Which modifiers are commonly relevant to billing CPT 27282?

What other CPT codes are commonly billed in association with pubic symphysis arthrodesis?

What clinical scenarios and pre/postoperative steps are associated with CPT 27282?

Which specialties typically perform or participate in this procedure and which payers are covered in the analysis?

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

What does CPT 27282 represent and where is this procedure typically performed?

Which modifiers are commonly relevant to billing CPT 27282?

What other CPT codes are commonly billed in association with pubic symphysis arthrodesis?

What clinical scenarios and pre/postoperative steps are associated with CPT 27282?

Which specialties typically perform or participate in this procedure and which payers are covered in the analysis?

References