Summary & Overview
CPT 27477: Epiphysiodesis of Proximal Tibia and Fibula for Limb-Length Correction
CPT code 27477 represents surgical epiphysiodesis of the proximal tibia and fibula—a targeted destruction of the growth plate to slow growth in a longer limb and allow the shorter limb to equalize in length. This pediatric and adolescent orthopedic procedure has implications for functional outcomes, surgical resource use, and payer coverage pathways given its elective but corrective nature. Nationally, the code matters for care coordination, surgical planning, and reimbursement consistency across commercial insurers and Medicare.
Key payers considered in this overview include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a clinical framing of the procedure, typical sites of service, and the service type. The publication also provides benchmarks and payer policy context where available, highlights coding and billing considerations tied to surgical care of limb-length discrepancy, and summarizes how this code fits into orthopedic service lines. Data not available in the input is noted explicitly where relevant. The content is intended to support coding teams, orthopedic providers, and payer policy analysts in understanding the clinical intent and administrative context of CPT code 27477.
Billing Code Overview
CPT code 27477 describes a surgical procedure that partially or completely destroys the epiphysis (growth plate) at the upper end of the tibia and fibula to slow growth of a longer leg so it matches a shorter leg. This procedure is a form of epiphysiodesis for limb-length discrepancy correction.
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Service type: Surgical orthopedic growth plate intervention
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Typical site of service: Hospital operating room or ambulatory surgical center
Data not available in the input for payers, associated taxonomies, ICD-10 diagnoses, and related codes.
Clinical & Coding Specifications
Clinical Context
A 12-year-old patient with progressive lower-extremity limb-length discrepancy is evaluated in pediatric orthopedic clinic. Clinical assessment includes growth prediction charts, standing long-leg radiographs, and discussion of options. The provider determines that temporary or permanent epiphysiodesis of the proximal tibial and proximal fibular growth plates is indicated to slow growth of the longer limb and allow the shorter limb to catch up. The procedure is typically performed in an operating room or ambulatory surgery center under general anesthesia with regional block as appropriate. Preoperative workflow includes informed consent, surgical planning with timing based on remaining growth (growth-plate assessment), pre-op clearance, and marking of laterality. Intraoperative steps include exposure of the proximal tibial and fibular physes, partial or complete physeal ablation or stapling/epiphysiodesis technique as indicated, hemostasis, and wound closure. Typical postoperative care involves short-term immobilization or dressing, discharge same day or overnight observation for pain control, postoperative radiographs at follow-up to confirm effect on growth, and scheduled growth and alignment monitoring until desired limb-length equalization is achieved. Common payors encountered include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, BUCA, and Medicare.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
LT | Left side | When the procedure is performed on the left lower extremity |