Summary & Overview
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.
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.
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Service type: Surgical orthopedic procedure — pelvic fusion/arthrodesis
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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 |