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    OpenPayerBilling CodesArthrodesis Procedures on the Pelvis and Hip JointCPT cpt-27282-pubic-symphysis-arthrodesis-with-autograft-and-fixation
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    CPT 27282: Pubic Symphysis Arthrodesis with Autograft and Fixation

    Medicare pays $818 on average nationally for this procedure.

    CPT code 27282 describes surgical arthrodesis (fusion) of the pubic symphysis with internal fixation devices and autologous bone graft to induce bony fusion; the service is an open pelvic surgical procedure typically performed in an operating room setting for stabilization of the anterior pelvic ring due to instability or nonunion.

    For related coverage guidance, see recent payer policy updates: Orthopedic Joint Procedures of the Knee for Managed Medicaid (MMC), Health and Recovery Plan (HARP), Child Health Plus (CHP), and Essential Plan (EP) Members, Autologous Chondrocyte Transplantation or Implantation Corporate Medical Policy, Autologous Platelet-Derived Growth Factors (Platelet-Rich Plasma [PRP]).

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    Table of contents

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    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.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    27280Open 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.
    20937Structural 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.
    20930Allograft, morselized, or placement of bone graft substituteMay be reported when bone graft substitute or allograft is used instead of autograft.
    20936Autograft 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.
    20680Removal 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.
    76000Fluoroscopy, surgical guidance (intraoperative)Used to report intraoperative imaging guidance when fluoroscopy is required for implant placement and reduction confirmation.

    Related Modifiers

    14 rows

    ModifierDescriptionWhen to Use
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
    23Modifier -23 (Unusual Anesthesia) is used on anesthesia service CPT codes when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia…- Use modifier -23 only on anesthesia CPT codes (00100–01999) when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia because of…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    63Modifier‑63 is appended to surgical CPT codes (20000–69990) when a procedure is performed on a neonate or infant weighing ≤ 4 kg (about 8.8 lbs). The AMA/AAPC definition specifies this use and notes…- Use modifier -63 only for surgical procedures in the CPT 20000–69990 series performed on a neonate or infant who weighs ≤ 4 kg at the time of the procedure; it indicates increased complexity due to…
    66Modifier 66 (Surgical Team) is used when three or more surgeons act as primary surgeons on a single, highly complex procedure. The AMA defines it for use when a surgical team — often composed of…- Use modifier 66 when three or more surgeons act as primary surgeons working collaboratively as a surgical team on a single, highly complex or difficult procedure (for example organ…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
    79Modifier 79 indicates a surgical procedure performed during the postoperative global period of a prior surgery that is unrelated to the original procedure. Per AMA/CPT and CMS guidance, it is…- Use modifier 79 when the same physician (or same‑specialty physician in the same group) performs a surgical procedure during the postoperative global period of a prior surgery and the new procedure…
    80CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…
    81Modifier -81 indicates a physician served as a minimal assistant surgeon for part—not all—of an operative procedure. Use when a physician’s assisting role is limited and does not represent full…- Use CPT modifier -81 when a physician acts as a minimum assistant surgeon who assists during only part (a limited portion) of an operative procedure; append -81 to the primary surgical CPT code to…
    50Modifier –50 (Bilateral Procedure) is appended to a CPT code when an identical procedure is performed on paired anatomical structures during the same operative session. The AMA states to add…- Use modifier -50 when the same CPT surgical, diagnostic, or radiology procedure is performed on paired anatomical structures (both sides of the body) during the same operative/session by the same…

    Showing 1–10 of 14

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    208000000X
    208U00000X
    2084P0800X
    207L00000X
    207QP0002X
    207RI0200X
    2278G0305X
    363LP1700X

    Related ICD-10-CM Codes

    23 rows

    ICD-10-CM CodeDescription
    M24.259Disorder of ligament, unspecified hip
    M25.859Other specified joint disorders, unspecified hip
    M25.861Other specified joint disorders, right knee
    M25.862Other specified joint disorders, left knee
    M81.0Age-related osteoporosis without current pathological fracture
    M84.452APathological fracture, left femur, initial encounter for fracture
    M84.452DPathological fracture, left femur, subsequent encounter for fracture with routine healing
    M84.452SPathological fracture, left femur, sequela
    M84.463APathological fracture, right fibula, initial encounter for fracture
    M84.463DPathological fracture, right fibula, subsequent encounter for fracture with routine healing

    Showing 1–10 of 23

    Related Payer Policy Updates

    Specialty: Orthopedics/Musculoskeletal1 / 2

    10 rows

    PolicyPayerEffective Date
    Orthopedic Joint Procedures of the Knee for Managed Medicaid (MMC), Health and Recovery Plan (HARP), Child Health Plus (CHP), and Essential Plan (EP) Membersuniverahealthcare2027-01-01
    Autologous Chondrocyte Transplantation or Implantation Corporate Medical Policybcbsvermont2026-12-01
    Autologous Platelet-Derived Growth Factors (Platelet-Rich Plasma [PRP])Cigna2026-10-15
    Metatarsophalangeal Joint ReplacementCigna2026-10-15
    Shoulder Arthroplasty (Total, Partial, Reverse, Revision and Resurfacing)univerahealthcare2026-10-15
    Hip Arthroplasty (partial and total hip replacement)univerahealthcare2026-10-15
    Artificial Lumbar Intervertebral Disc (Lumbar Total Disc Arthroplasty)univerahealthcare2026-10-15
    Osteochondral Grafting of the Kneeuniverahealthcare2026-10-15
    Lumbar Fusion (arthrodesis) with decompressionuniverahealthcare2026-10-15
    Metal-on-Metal Total Hip Resurfacinguniverahealthcare2026-10-15

    Related Codes

    CPT-27278-SACROILIAC-JOINT-FUSION-PERCUTANEOUS-MINIMALLY-INVASIVE

    CPT 27278: Unilateral Sacroiliac Joint Fusion, Percutaneous

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

    CPT 27279: Unilateral Minimally Invasive Sacroiliac Joint Fusion

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

    CPT 27280: Open Sacroiliac Joint Fusion with Autograft

    CPT-27284-HIP-ARTHRODESIS-WITH-AUTOGRAFT

    CPT 27284: Hip Arthrodesis with Autograft

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

    CPT 27286: Hip Arthrodesis with Autograft and Subtrochanteric Osteotomy

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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