Summary & Overview
CPT 27517: Closed Reduction, Distal Femoral Epiphyseal Separation
CPT code 27517 denotes a closed reduction of distal femoral epiphyseal separation with manipulation, a procedure aimed at realigning and stabilizing growth-plate injuries of the distal femur. These injuries primarily affect children and adolescents and can be missed without careful clinical and radiographic assessment; timely and appropriate reduction is critical to restoring anatomic alignment and minimizing long-term growth disturbances. Nationally, this code is used to capture surgical management of pediatric distal femoral epiphyseal separations across hospital, ambulatory surgery center, and emergency settings.
Key payers in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication provides clinicians, billing specialists, and policy analysts with benchmarks on code utilization and service patterns, a concise clinical context for when the code applies, and guidance on typical sites of service. It also highlights common modifiers and payer considerations for claims processing and expected care settings.
Readers will learn the clinical intent of the code, where the procedure is most often performed, payer coverage landscape, and operational points relevant to coding and billing workflows. Data not available in the input is clearly noted where applicable.
Billing Code Overview
CPT code 27517 describes a closed reduction of distal femoral epiphyseal separation with manipulation, in which the provider reduces and stabilizes a separation or fracture of the distal femoral growth plate. The procedure may employ skin or skeletal traction as part of the reduction and stabilization process.
Service type: Orthopedic closed reduction procedure for pediatric epiphyseal (growth plate) injury
Typical site of service: Operating room or procedure suite within a hospital or ambulatory surgery center; may also occur in an emergency department or inpatient setting depending on patient age and injury severity.
Clinical & Coding Specifications
Clinical Context
A 10-year-old child presents to the emergency department after a fall from playground equipment with acute distal thigh pain, swelling and inability to bear weight. Physical exam shows tenderness over the distal femur and the clinician suspects an epiphyseal (growth plate) injury. Plain radiographs confirm a distal femoral epiphyseal separation (Salter-Harris fracture involving the distal femoral physis). The orthopedic surgeon performs a closed reduction under conscious sedation or general anesthesia in the operating room or procedure suite. The procedure includes manipulation to realign the epiphysis with the metaphysis; skin or skeletal traction may be used temporarily to maintain reduction prior to immobilization. Post-reduction radiographs confirm alignment. The patient is placed in immobilization (long leg cast or spica/hinged brace depending on age and stability) and discharged with outpatient orthopedic follow-up.
Typical site of service: hospital emergency department procedural suite, ambulatory surgery center, or inpatient operating room depending on sedation/anesthesia needs and patient age.
Service type: closed reduction of distal femoral epiphyseal separation with manipulation, may include use of skin or skeletal traction and intra-procedural imaging for confirmation.
Typical patient scenario: pediatric patient with Salter-Harris distal femoral fracture presenting acutely after trauma, requiring urgent closed reduction and stabilization to restore alignment and protect the physis.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|