Summary & Overview
CPT 27520: Closed Reduction of Patella Fracture
CPT code 27520 represents a closed reduction procedure for patellar (kneecap) fractures performed without open manipulation. This code captures a nonoperative technique used to restore patellar alignment and stability, typically in acute fracture management where closed methods are adequate. Nationally, accurate coding of this procedure influences clinical documentation, facility and professional billing, and aggregate utilization reporting for orthopedic trauma care.
Key payers addressed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical context for when closed reduction of the patella is used, plus practical billing considerations tied to site of service and service line classification. The publication provides benchmarks and policy-relevant points such as typical places of service (hospital OR, outpatient surgical center, emergency department), common modifiers and coding nuances where available, and how this code fits into broader orthopedic procedural coding sets.
The content is intended for coding professionals, billing managers, and clinicians seeking a clear summary of CPT code 27520, its clinical role, and the payer landscape relevant to national billing and reimbursement patterns.
Billing Code Overview
CPT code 27520 describes a closed reduction of a patella (knee cap) fracture without manipulation. The procedure is performed to restore and maintain a stable patellar position after a fracture, using nonopen techniques to realign bony fragments.
Service type: Closed orthopedic fracture reduction
Typical site of service: Hospital operating room, outpatient surgical center, or emergency department procedural area depending on clinical stability and facility resources.
Clinical & Coding Specifications
Clinical Context
A 34-year-old male arrives at the emergency department after a fall onto his knee while skiing. He complains of anterior knee pain, swelling, and inability to extend the knee. Radiographs demonstrate a nondisplaced or minimally displaced fracture of the patella. The orthopedic surgeon evaluates the patient, documents neurovascular status, obtains plain radiographs (AP, lateral, sunrise), and determines that the fracture can be managed without open surgical fixation. A closed reduction is attempted in the ED or procedure suite without manipulation under anesthesia beyond local or moderate sedation because the fracture fragments are stable or only minimally displaced. Post-reduction radiographs confirm a stable patellar position. The knee is immobilized in a cast or knee immobilizer and a plan for outpatient orthopedic follow-up is arranged. Typical site of service: emergency department, ambulatory surgical center, or hospital outpatient department. Service type: closed reduction procedure of a patellar (knee cap) fracture performed without manipulation to restore a stable patellar position.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
25 | Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure | Use when a distinct E/M visit is performed and documented in addition to 27520 on the same date. |
| | Bilateral procedure | Use when closed reduction is performed on both patellae during the same encounter (rare).