Summary & Overview
CPT 27357: Femoral Bone Cyst Excision with Autograft
CPT code 27357 designates surgical excision of a bone cyst in the femur with autograft reconstruction. This orthopedic operative code is clinically important because femoral bone cysts can cause pain, pathologic fracture risk, and limited joint mobility; excision with autograft aims to restore structural integrity and function. Nationally, utilization patterns for this code reflect orthopedic surgical caseloads and repair of focal bone lesions in both pediatric and adult populations.
Key payers addressed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the code’s clinical intent and common settings, plus what to expect when benchmarking this service: procedural definitions, common sites of service, and payer coverage considerations. The publication outlines typical billing context for 27357, highlights common modifiers used with surgical codes (provided in the input), and identifies areas where documentation and coding specificity affect reimbursement and audit risk.
This resource provides clinicians, coding professionals, and policy analysts with practical context for applying CPT code 27357, clarifying the procedure’s purpose and typical care setting, and summarizing what stakeholders commonly review when evaluating claims for femoral bone cyst excision with autograft.
Billing Code Overview
CPT code 27357 describes a surgical procedure to remove a bone cyst from the femur using an autograft. The procedure is performed to relieve pain and improve range of motion by excising the cystic lesion and filling the defect with the patient’s own bone graft.
Service Type: Surgical — Orthopedic procedure
Typical Site of Service: Inpatient or outpatient surgical center, commonly performed in an operating room under appropriate anesthesia.
Clinical & Coding Specifications
Clinical Context
A typical patient is a 12–25-year-old with an expansile bone cyst in the proximal femur presenting with progressive hip or thigh pain, localized tenderness, and limited range of motion. Imaging (plain radiographs and MRI) demonstrates a solitary unicameral or aneurysmal bone cyst that threatens cortical integrity or has caused a pathologic fracture. The orthopedic surgeon schedules operative curettage of the cyst with autograft placement to obliterate the cavity, restore structural support, and relieve symptoms. The clinical workflow includes preoperative imaging and planning, informed consent discussing risks and benefits, preoperative medical clearance, anesthesia evaluation (general or regional), intraoperative cyst curettage and graft harvest (commonly from the iliac crest), placement of autologous bone graft into the femoral defect, intraoperative imaging confirmation, and standard postoperative recovery with pain control, short-term immobilization or limited weight-bearing, and outpatient orthopedic follow-up with repeat imaging to assess healing and graft incorporation.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when intraoperative complexity (extensive curettage, difficult graft harvest) substantially increases operative work beyond typical for 27357. |