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    OpenPayerBilling CodesRepair, Revision, and/or Reconstruction Procedures on the Femur (Thigh Region) and Knee JointCPT cpt-27472-femur-nonunion-malunion-repair-with-bone-graft
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    CPT 27472: Open Repair of Femoral Shaft Nonunion with Bone Graft

    Medicare pays $1174 on average nationally for this procedure.

    CPT code 27472 describes an open surgical repair of a femoral shaft nonunion or malunion (fracture below the femoral head and neck) with autogenous bone graft harvested from the iliac crest or another donor site; service type: surgical open fracture repair with bone grafting; typical site of service: inpatient or outpatient hospital operating room or ambulatory surgical center where orthopedic reconstruction is performed.

    For related coverage guidance, see recent payer policy updates: Hip Arthroplasty (partial and total hip replacement), Shoulder Arthroplasty (Total, Partial, Reverse, Revision and Resurfacing), Artificial Lumbar Intervertebral Disc (Lumbar Total Disc Arthroplasty).

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    Clinical & Coding Specifications

    Clinical Context

    A 62-year-old male presents with persistent lateral thigh pain and difficulty ambulating nine months after a displaced mid-shaft femoral fracture treated initially with intramedullary nailing at an outside hospital. Serial radiographs and CT show failure of fracture healing with a symptomatic nonunion distal to the femoral head and neck. The orthopedic trauma surgeon schedules an operative revision: open repair of the femoral nonunion with debridement of fibrous tissue, revision fixation and structural and/or cancellous autogenous bone graft harvested from the iliac crest to promote union. The typical clinical workflow includes preoperative optimization (medical clearance, imaging, and surgical consent), intraoperative procedure (exposure of the nonunion, removal or revision of hardware as needed, decortication, fixation revision, iliac crest bone graft harvest and placement), and postoperative care (pain control, weight-bearing restrictions, infection surveillance, and radiographic follow-up). Typical site of service is an inpatient or outpatient hospital operating room or ambulatory surgery center for complex reconstructive fixation depending on patient comorbidities and anesthesia needs.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    27472Repair, nonunion or malunion, femur, below head and neck; with bone graft (includes obtaining graft)Primary procedure — open repair of femoral nonunion with autogenous bone graft harvest and placement.
    20930Allograft, morselized, or placement of osteopromotive material, for spine, long bone, or pelvis; per graftMay be used if additional allograft or osteoinductive materials are implanted alongside autograft.
    20936Autograft, tibia or fibula, structural, includes obtaining graftUsed if a structural autograft from another site (tibia/fibula) is used instead of iliac crest.
    11010Debridement of open fracture wound, includes removal of foreign material and irrigation; simple, for open fracturesMay be performed if the nonunion site requires formal debridement prior to definitive fixation (concurrent or prior).
    20680Removal of deep implant (e.g., nail)Performed when previous internal fixation hardware is removed as part of the nonunion repair.
    27075Open treatment of proximal femoral fracture, includes internal fixation, with or without bone graftRelated proximal femur fixation procedures that may be used depending on nonunion location and technique.

    Related Modifiers

    10 rows

    ModifierDescriptionWhen to Use
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    80CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…
    81Modifier -81 indicates a physician served as a minimal assistant surgeon for part—not all—of an operative procedure. Use when a physician’s assisting role is limited and does not represent full…- Use CPT modifier -81 when a physician acts as a minimum assistant surgeon who assists during only part (a limited portion) of an operative procedure; append -81 to the primary surgical CPT code to…
    82Modifier 82 is appended to a surgical CPT code to indicate that an attending physician acted as an assistant because a qualified resident surgeon was unavailable. In teaching hospitals it documents…- When to use: Append modifier 82 in teaching-hospital settings to indicate a physician served as an assistant surgeon because a qualified resident surgeon was unavailable (includes situations where…
    50Modifier –50 (Bilateral Procedure) is appended to a CPT code when an identical procedure is performed on paired anatomical structures during the same operative session. The AMA states to add…- Use modifier -50 when the same CPT surgical, diagnostic, or radiology procedure is performed on paired anatomical structures (both sides of the body) during the same operative/session by the same…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    55Modifier –55 indicates the billing provider furnished only postoperative management for a procedure that has a global surgical period. According to AAPC, this modifier is appended to the same CPT…- Use modifier -55 when billing the same CPT surgical code that has a 10- or 90-day global period and you, as a provider other than the original surgeon, furnished ONLY postoperative management (no…
    58Modifier 58 (Staged or related procedure/service by the same physician during the postoperative period) indicates that a subsequent procedure performed by the same provider during the…- Use modifier 58 when the same physician/QHP performs a procedure during the postoperative/global period of an earlier procedure and the subsequent procedure is either planned or anticipated…
    76Modifier -76, Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional, is appended when the same provider performs an identical, medically necessary procedure or…- Use modifier -76 when the same physician or other qualified health care professional performs an identical procedure or service a second (or subsequent) time on the same date of service and the…

    Related Provider Taxonomies

    8 rows

    Taxonomy CodeSpecialtyNotes
    207W00000XOphthalmology PhysicianAn ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically train…
    2080P0207XPediatric Hematology & Oncology PhysicianA pediatrician trained in the combination of pediatrics, hematology and oncology to recognize and manage pediatric blood disorders and cancerous disea…
    207L00000XAnesthesiology PhysicianAn anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an opera…
    207K00000XAllergy & Immunology PhysicianAn allergist-immunologist is trained in evaluation, physical and laboratory diagnosis, and management of disorders involving the immune system. Select…
    102X00000XPoetry TherapistA medical or mental health professional who has attained credentials after satisfactorily completing a poetry therapy training program approved by the…
    332G00000XEye BankAn eye bank procures and distributes eyes for transplant, education and research. To promote patient safety, donated eyes and donor medial histories a…
    2083B0002XObesity Medicine (Preventive Medicine) PhysicianA physician who specializes in the treatment of obesity demonstrates competency in and a thorough understanding of the treatment of obesity and the ge…
    363LP2300XPrimary Care Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers · Nurse Practitioner

    Related Payer Policy Updates

    Specialty: Orthopedics/Musculoskeletal1 / 3

    7 rows

    PolicyPayerEffective Date
    Hip Arthroplasty (partial and total hip replacement)univerahealthcare2026-10-15
    Shoulder Arthroplasty (Total, Partial, Reverse, Revision and Resurfacing)univerahealthcare2026-10-15
    Artificial Lumbar Intervertebral Disc (Lumbar Total Disc Arthroplasty)univerahealthcare2026-10-15
    Metal-on-Metal Total Hip Resurfacinguniverahealthcare2026-10-15
    Lumbar Fusion (arthrodesis) with decompressionuniverahealthcare2026-10-15
    Osteochondral Grafting of the Kneeuniverahealthcare2026-10-15
    Sacroiliac Joint Fusion or Stabilizationuniverahealthcare2026-10-15

    Related Codes

    CPT-27380-INFRAPATELLAR-TENDON-PRIMARY-REPAIR

    CPT 27380: Primary Repair of Infrapatellar (Patellar) Tendon

    CPT-27381-SECONDARY-INFRAPATELLAR-TENDON-REPAIR

    CPT 27381: Secondary Repair of Infrapatellar Tendon

    CPT-27385-HAMSTRING-QUADRICEPS-RUPTURE-REPAIR-SUTURE

    CPT 27385: Primary Repair of Hamstring or Quadriceps Rupture

    CPT-27386-SECONDARY-QUADRICEPS-HAMSTRING-REPAIR-AUTOGRAFT

    CPT 27386: Secondary Repair of Quadriceps or Hamstring with Graft

    CPT-27390-OPEN-TENOTOMY-HAMSTRING-SINGLE-TENDON

    CPT 27390: Open Tenotomy of Hamstring Tendon

    CPT-27391-OPEN-HAMSTRING-TENOTOMY

    CPT 27391: Open Tenotomy of Multiple Hamstring Tendons

    CPT-27392-OPEN-TENOTOMY-HAMSTRING-BILATERAL

    CPT 27392: Open Bilateral Hamstring Tenotomy

    CPT-27393-HAMSTRING-TENDON-LENGTHENING

    CPT 27393: Hamstring Tendon Lengthening

    CPT-27394-HAMSTRING-TENDON-LENGTHENING-UNILATERAL

    CPT 27394: Hamstring Tendon Lengthening, Unilateral

    CPT-27395-HAMSTRING-TENDON-LENGTHENING-BILATERAL

    CPT 27395: Bilateral Hamstring Tendon Lengthening

    Showing 1–10 of 59

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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