Summary & Overview
CPT 27347: Excision of Meniscal or Capsular Knee Lesion
CPT code 27347 represents surgical excision of a lesion, such as a cyst or ganglion, from the meniscus or capsule of the knee. This targeted procedure addresses pain and mechanical symptoms from intra-articular or peri-meniscal lesions and is commonly performed in ambulatory surgery centers and hospital operating rooms. Nationally, the code matters for specialty orthopaedic billing, surgical utilization monitoring, and payer coverage determinations related to knee-preserving interventions.
Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical context for the procedure, typical sites of service, common modifiers observed on claims, and which payers are most often involved in coverage and prior authorization processes. The publication summarizes national benchmarks where available and highlights policy and coding considerations affecting reimbursement and claim adjudication.
This report is designed to help billing managers, orthopaedic surgeons, and policy analysts understand how CPT code 27347 is used in clinical practice, what to expect for site-of-service patterns, and where to look for payer-specific rules and prior authorization requirements. Data not available in the input will be noted as such in relevant sections.
Billing Code Overview
CPT code 27347 describes the surgical removal of a lesion, such as a cyst or ganglion, from the meniscus or capsule of the knee. The procedure is performed to eliminate pain or mechanical symptoms caused by the lesion.
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Service type: Surgical excision of knee meniscal or capsular lesion
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Typical site of service: Ambulatory surgery center or hospital operating room
Clinical & Coding Specifications
Clinical Context
A 35-year-old recreational runner presents to an outpatient orthopedic clinic with six months of anterior knee pain and intermittent mechanical catching. MRI demonstrates a symptomatic meniscal cyst adjacent to the medial meniscus with local joint-line tenderness. Conservative care including activity modification, NSAIDs, and physical therapy failed to resolve symptoms. The orthopedic surgeon schedules a knee arthrotomy/arthroscopy for excision of the meniscal/capsular lesion to relieve pain and mechanical symptoms. The typical workflow: preoperative evaluation and informed consent in clinic, pre-op anesthesia assessment, intraoperative arthroscopic visualization and identification of the cyst or ganglion, surgical excision of the lesion and any required meniscal debridement, hemostasis and closure, postoperative recovery in the ambulatory surgery center or hospital, and outpatient follow-up with wound check and rehabilitation as indicated. Typical site of service is an ambulatory surgery center or hospital outpatient department. Service type is minor to moderate orthopedic surgical procedure for lesion excision of the knee meniscus/capsule (operative).
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
50 | Bilateral procedure | When identical procedures are performed on both knees during the same operative session |