Summary & Overview
CPT 27303: Incision of Bone Cortex, Upper Leg/Knee
CPT code 27303 defines a surgical incision of the bone cortex to relieve pain, pressure, or infection at a localized site in the upper leg or knee, commonly used for conditions such as osteomyelitis or a bone abscess. This code matters nationally because it captures a targeted orthopedic surgical intervention with implications for surgical utilization, infection management, and post-operative resource use across inpatient and ambulatory surgical settings. Payers commonly relevant to analyses of this service include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical intent and typical sites of service, plus what to expect in payer coverage context nationally. The publication summarizes benchmarks for utilization and reimbursement patterns where available, highlights policy and coding considerations that affect claims processing, and outlines the clinical context influencing service frequency. Data not available in the input for specific associated taxonomies, ICD-10 diagnoses, related codes, or service-line breakdowns is noted as unavailable. The piece is intended to inform coding professionals, billing teams, and policy analysts about the procedural scope and payer landscape for CPT code 27303 without clinical recommendations.
Billing Code Overview
CPT code 27303 describes a surgical procedure in which the provider incises the bone cortex to relieve pain, pressure, or infection, for example in cases such as osteomyelitis or a localized bone abscess. The procedure targets a localized site on the upper leg or knee area.
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Service type: Surgical debridement/incision of bone cortex for relief of pain, pressure, or infection
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Typical site of service: Operating room or procedure suite for the upper leg or knee region
Clinical & Coding Specifications
Clinical Context
A 54-year-old patient presents with localized severe pain, swelling, and erythema over the distal femur/knee region with focal point tenderness and purulent drainage from a previous wound. Imaging (plain radiograph and MRI) and laboratory studies including elevated inflammatory markers support a diagnosis of a localized bone abscess/osteomyelitis of the femur near the knee. The orthopedic surgeon performs surgical cortical incision and drainage of the involved cortical bone to decompress the abscess, obtain cultures, and remove necrotic bone. The workflow includes preoperative assessment and consent, targeted imaging review, administration of regional or general anesthesia, sterile preparation of the upper leg/knee, incision through soft tissue to bone, cortical fenestration or trephination to drain purulence and debride necrotic bone, collection of specimens for microbiology, irrigation, hemostasis, closure or packing as indicated, and postoperative monitoring with culture-directed antibiotic therapy and wound care follow-up. Typical site of service is an operating room or procedure room in an acute hospital or ambulatory surgical center when otherwise appropriate.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
11 | Normal/standard service | When the procedure is performed as planned without unusual events |
22 |