Summary & Overview
CPT 27355: Excision of Benign Femoral Tumor or Cyst
CPT code 27355 denotes surgical excision of a benign tumor or cyst from the femur. This orthopedic procedure is clinically important because it addresses pain and impaired joint or limb mobility caused by osseous lesions and can prevent progression to fracture or functional decline. Nationally, coverage and payment for surgical bone lesion excision affect access to timely orthopedic care, perioperative planning, and facility utilization.
Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context for 27355, common sites of service, and the types of documentation and case mix that typically accompany such procedures. The publication also summarizes benchmark payment patterns, claim-line considerations, and recent policy clarifications relevant to surgical excision of benign femoral lesions. Where available, comparative metrics across major payers are presented to inform billing accuracy and coding consistency.
The content targets coders, orthopedic clinicians, revenue cycle professionals, and policy analysts seeking a clear, national-level briefing on CPT code 27355, its clinical role, and implications for claims processing and payer interactions.
Billing Code Overview
CPT code 27355 describes a surgical procedure to remove a benign tumor or cyst from the femur. The procedure is performed to reduce pain and improve range of motion by excising the lesion from bone tissue.
-
Service type: Surgical excision of bone lesion (orthopedic procedure)
-
Typical site of service: Hospital inpatient or outpatient surgical center, operating room or orthopedic procedure suite
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A 45-year-old patient presents with progressive lateral thigh pain and limited hip range of motion. Imaging (X-ray and MRI) identifies a well-circumscribed benign osseous lesion (eg, osteochondroma or enchondroma) arising from the distal femur causing mechanical impingement and pain. Conservative management including activity modification and analgesics failed over several months. The orthopedic surgeon schedules an excision of the benign tumor/cyst from the femur to relieve pain and restore motion. Preoperative steps include history and physical, informed consent, pre-anesthesia evaluation, and imaging review. The procedure is typically performed in an operating room or ambulatory surgery center under general or regional anesthesia. Intraoperative workflow includes localization of the lesion (often with fluoroscopy), surgical exposure of the femur, careful resection of the benign tumor or cyst with preservation of surrounding neurovascular structures, and hemostasis. Specimens are sent for pathology to confirm benign histology. Postoperative care includes pain control, wound care instructions, mobilization as tolerated, and follow-up clinic visit with repeat imaging as indicated to assess healing and ensure no recurrence.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when work or complexity is substantially greater than usual for 27355 due to severe scar tissue, atypical anatomy, or prolonged operative time. |