Summary & Overview
CPT 27340: Excision of Prepatellar Bursa
CPT code 27340 identifies the surgical excision of the prepatellar bursa, an operative treatment used to relieve anterior knee pain and persistent prepatellar bursitis. Nationally, this code matters because it represents a commonly billed minor orthopedic procedure performed in ambulatory surgery centers and hospital operating rooms, with implications for procedural utilization, site-of-service trends, and per-case cost analysis.
Key payers in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical context for the procedure, typical sites of service, and the payer landscape for reimbursement and coverage considerations. The publication outlines benchmarks for utilization and payments where available, summarizes relevant policy updates affecting coverage and site-of-service payment differentials, and provides clinical context to inform coding accuracy and documentation.
The report is written for a national audience and focuses on practical information: what the code represents, how it is typically used in clinical practice, which major payers commonly cover the service, and where to look for policy or reimbursement changes that could affect provider billing and patient access.
Billing Code Overview
CPT code 27340 describes the surgical excision of the prepatellar bursa, a fluid-filled sac located in front of the knee. The procedure is performed to remove inflamed or diseased bursal tissue and relieve anterior knee pain and local swelling.
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Service type: Surgical excision (open procedure)
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Typical site of service: Outpatient surgical center or hospital operating room
Clinical & Coding Specifications
Clinical Context
A 48-year-old construction worker presents with a several-month history of anterior knee pain and swelling localized to the area directly over the patella. Conservative care including activity modification, NSAIDs, aspiration, and corticosteroid injection provided only temporary relief. On exam there is a tender, fluctuant prepatellar swelling consistent with chronic prepatellar bursitis. The orthopedic surgeon schedules an elective outpatient excision of the prepatellar bursa (CPT 27340) under regional or general anesthesia. Typical workflow: preoperative evaluation and informed consent, anesthesia clearance, operative removal of the bursa with hemostasis and layered closure, postoperative recovery with wound care instructions, and short-term activity restrictions. Typical site of service is an ambulatory surgery center or hospital outpatient department. The procedure is performed to relieve persistent pain, recurrent effusion, and functional limitation after failed conservative management.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when work or time is substantially greater than usual for CPT 27340 and well documented. |