Summary & Overview
CPT 27335: Knee Arthrotomy with Anterior and Posterior Synovectomy
CPT code 27335 denotes a surgical knee arthrotomy with anterior and posterior synovectomy that includes the popliteal area. The procedure involves opening the knee joint and removing diseased synovial tissue from multiple compartments to reduce pain and restore gait function. As a relatively specialized orthopedic procedure, it is relevant for hospitals, surgical centers, and orthopedic practices managing complex inflammatory or mechanical synovial disease.
Key payers in this national overview include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find clinical context about the procedure, typical sites of service, and operational considerations for coding and billing. The publication summarizes benchmark elements commonly reviewed by payers (authorization triggers, site-of-service implications, and coding relationships) and highlights areas where policy updates or payer-specific requirements often affect coverage and claim adjudication.
This summary equips coding professionals, billing managers, and compliance staff with a concise reference to the clinical intent of CPT code 27335, the typical care settings, and the payer environment to expect nationally. Data not available in the input is noted where applicable in detailed sections.
Billing Code Overview
CPT code 27335 describes an arthrotomy of the knee joint with anterior and posterior synovectomy including the popliteal area. The procedure is performed to relieve pain and improve gait by surgically opening the knee joint and removing inflamed synovial tissue from both anterior and posterior compartments, extending into the popliteal region.
Service Type: Surgical — Knee Arthrotomy with Synovectomy
Typical Site of Service: Inpatient or outpatient hospital setting (operating room)
Clinical & Coding Specifications
Clinical Context
A typical patient is a 55-year-old with chronic inflammatory synovitis of the knee (often rheumatoid arthritis or post-traumatic synovitis) presenting with progressive pain, swelling, mechanical stiffness, and impaired gait despite optimized medical management including disease-modifying agents, intra-articular injections, and physical therapy. Physical exam shows effusion, limited range of motion, and tenderness in the anterior and posterior compartments; imaging (MRI or radiographs) demonstrates synovial hypertrophy with impingement or recurrent effusion and no indication for immediate joint replacement. The orthopedic surgeon schedules an operative arthrotomy with extensive anterior and posterior synovectomy including the popliteal area (CPT 27335) to remove inflamed synovium, reduce pain, improve range of motion, and restore gait.
The clinical workflow includes preoperative evaluation (history, medication reconciliation, optimization of inflammatory disease control), informed consent discussing risks (infection, stiffness, neurovascular injury in the popliteal region), anesthesia assessment (regional or general), operative arthrotomy with anterior and posterior synovectomy, postoperative pain control and DVT prophylaxis, early mobilization with physical therapy, and follow-up visits to monitor wound healing and functional recovery. Typical site of service is an inpatient hospital operating room or outpatient ambulatory surgery center depending on comorbidity and anticipated complexity. Service type is operative surgical synovectomy/arthrotomy of the knee.
Coding Specifications
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