Summary & Overview
CPT 27286: Hip Immobilization with Autologous Bone Graft and Osteotomy
CPT code 27286 represents an orthopedic surgical procedure that immobilizes the hip joint using fixation devices, incorporates autologous bone grafting to induce bone formation, and includes a subtrochanteric osteotomy of the femur. This code captures complex reconstructive work on the proximal femur and hip joint and is used in cases requiring stabilization and realignment with bone grafting.
The analysis covers national payer practices including Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find clinical context on the procedure type and typical sites of service, plus operational benchmarks and policy considerations relevant to billing and coverage for complex hip reconstruction. Key topics include typical utilization settings (inpatient and ambulatory surgical centers), common documentation elements needed to support medical necessity, and how payers approach coverage of combined fixation, grafting, and osteotomy procedures.
This publication provides clinicians, coding staff, and policy analysts a concise reference for understanding what CPT code 27286 represents, why it matters for reimbursement and care pathways nationally, and where to focus clinical documentation and prior authorization efforts. Data not available in the input are explicitly noted in the detailed sections.
Billing Code Overview
CPT code 27286 describes a surgical procedure that achieves hip joint immobilization using fixation devices combined with autologous bone grafting and subtrochanteric osteotomy. The provider surgically stabilizes the hip joint, induces new bone formation at the joint site using a graft harvested from another part of the patient's body, and performs a subtrochanteric osteotomy to divide and realign the femoral shaft just below the lesser trochanter.
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Service type: Surgical orthopedic procedure involving internal fixation, bone grafting, and femoral osteotomy
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Typical site of service: Inpatient hospital or ambulatory surgical center (operating room)
Data not available in the input for associated taxonomies, ICD-10 diagnoses, and related codes.
Clinical & Coding Specifications
Clinical Context
A 32-year-old adult with a history of developmental dysplasia of the hip and progressive pain and instability presents for surgical reconstruction. Conservative management failed. Preoperative imaging demonstrates femoral deformity with abnormal neck-shaft angle and joint incongruity. The orthopedic surgeon plans a surgical hip arthrodesis with autologous bone grafting and a subtrochanteric osteotomy to correct femoral alignment and stabilize the hip.
The clinical workflow includes: preoperative assessment and optimization, informed consent specifying autograft harvest site (commonly iliac crest), operative fixation of the hip joint with internal fixation devices, harvest and placement of autogenous bone graft to promote fusion, performance of a subtrochanteric osteotomy to correct femoral deformity, intraoperative fluoroscopy for alignment and hardware placement, postoperative pain control and DVT prophylaxis, inpatient recovery with early mobilization as allowed, and outpatient follow-up for wound checks, radiographic assessment of fusion, and hardware evaluation.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | Unmodified procedure | Default for a standard service without modifier reporting requirements |
11 |