Summary & Overview
CPT 27560: Closed Reduction of Dislocated Patella
CPT code 27560 denotes a closed manual reduction of a dislocated patella, a brief orthopedic intervention used to restore kneecap alignment without incision or anesthesia. This code is commonly used across emergency departments, urgent care centers, and outpatient orthopedic clinics when immediate, nonoperative management of a patellar dislocation is required. Nationally, accurate use of this code matters for capturing the incidence of acute knee dislocations, ensuring appropriate facility and professional payment, and tracking resource use in acute musculoskeletal care.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of coding intent and clinical context, payer coverage patterns where available, common billing modifiers, and related coding considerations. The publication also highlights benchmarks and policy updates relevant to acute orthopedic procedures, clarifies typical sites of service for billing purposes, and outlines areas where supplemental clinical documentation supports correct code assignment. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 27560 describes a closed manual reduction of a dislocated patella in which the provider repositions the kneecap without breaking the skin and without the use of anesthesia. The service type is a short, hands-on orthopedic procedure to restore normal patellar alignment. The typical site of service is the emergency department or an urgent care setting, and it may also be performed in an outpatient clinic equipped to manage acute musculoskeletal injuries when immediate reduction is indicated.
Clinical & Coding Specifications
Clinical Context
A typical scenario involves an adult or adolescent presenting to the emergency department or urgent care after an acute lateral patellar dislocation sustained during a sports injury or fall. The patient reports immediate anterior knee pain, visible deformity or the patella displaced laterally, inability to actively straight leg raise, and often swelling. Initial evaluation includes focused history, neurovascular exam, assessment for open injury (none present for this CPT), and plain radiographs of the knee to exclude fractures. The provider performs a closed reduction of the patella (27560) at bedside without a surgical incision and typically without general anesthesia; procedural analgesia or local infiltration may be used per facility protocols. Post-reduction, the provider documents confirmation of reduction by physical exam and repeat imaging if indicated, assesses distal pulses and neurologic status, applies immobilization (e.g., knee brace or sling), provides discharge instructions including weight-bearing status, and arranges orthopedic follow-up for rehabilitation and consideration of advanced imaging if instability or osteochondral injury is suspected. Typical sites of service are the emergency department, urgent care clinic, or outpatient orthopedic clinic. The service type is a closed (nonoperative) joint reduction procedure performed by orthopedic, emergency medicine, or sports medicine clinicians.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
23 |