CPT 27566 Open Patellectomy Reimbursement | OpenPayer

Summary & Overview

CPT 27566: Open Reduction of Dislocated Patella, ± Patellectomy

CPT code 27566 represents an open surgical procedure to reduce a dislocated patella and, when necessary, partially or completely remove the patella (patellectomy). This code captures definitive operative management of patellar instability and related traumatic or recurrent dislocations. Nationally, accurate coding for 27566 matters for appropriate surgical case classification, facility and professional payment, and tracking utilization of operative patellar stabilization techniques.

Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication provides a concise overview of clinical context for the procedure, typical sites of service (hospital inpatient or outpatient surgical center), and common billing considerations. Readers will find benchmarks and comparisons across major payers where available, notes on coding specificity for open patellar reduction with or without patellectomy, and context about how this procedure fits into orthopedic surgical service lines.

The report is intended for billing managers, orthopedic surgeons, compliance officers, and policy analysts seeking a national-level summary of clinical definition, payer coverage landscape, and practical coding context for CPT code 27566. Data not available in the input is noted where applicable.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare27566CPTorthopedic surgerypatellar dislocationpatellectomyknee surgerysurgical codinginpatient outpatient

Billing Code Overview

CPT code 27566 describes an open reduction of the patella (knee cap) to correct patellar dislocation, and may include partial or complete patellectomy when removal is performed. This procedure is a surgical orthopedic intervention focused on restoring patellar alignment and stabilizing the extensor mechanism of the knee.

Service Type: Open surgical orthopedic procedure — patellar reduction ± patellectomy

Typical Site of Service: Hospital inpatient or outpatient surgical center

Clinical & Coding Specifications

Clinical Context

A typical patient is a 20–40-year-old adult who presents after recurrent lateral patellar dislocations with persistent instability, pain, and functional limitation despite conservative care (physical therapy, bracing). The patient often reports a history of twisting injury or a direct blow to the knee followed by visible patellar displacement, swelling, and difficulty bearing weight. Preoperative workup includes history and physical exam focused on patellar tracking, plain radiographs (AP, lateral, sunrise) to assess patellar position and joint surfaces, and MRI to evaluate osteochondral injury, medial patellofemoral ligament (MPFL) rupture, and trochlear dysplasia.

Surgical workflow: After informed consent and anesthesia (general or regional), the patient is positioned supine with a thigh tourniquet as indicated. A standard anterior or lateral parapatellar approach is used to expose the patella and extensor mechanism. Open reduction maneuvers are performed to realign the patella into the trochlear groove; if irreducible or compromised, the surgeon may perform partial or total patellectomy as described in 27566. Concurrent procedures often include MPFL repair/reconstruction, lateral retinacular lengthening or release, tibial tubercle realignment (osteotomy), and repair of osteochondral fragments. Postoperative care includes pain control, immobilization or brace, progressive range-of-motion exercises, and staged rehabilitation to restore quadriceps strength and patellar stability. Typical sites of service are an outpatient ambulatory surgical center or hospital operating room depending on complexity and comorbidities. Common payors include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, BUCA, and Medicare.

Coding Specifications

Modifier	Description	When to Use

CPT 27552: Closed Reduction of Knee Dislocation under Anesthesia

27507-OPEN-TREATMENT-OF-FEMORAL-SHAFT-FRACTURE-WITH-PLATESCREWS

CPT 27507: Open Fixation of Femoral Shaft Fracture with Plate and Screws

CPT-27524-PATELLAR-FRACTURE-ORIF-PATELLECTOMY-SOFT-TISSUE-REPAIR

CPT 27524: Open Reduction Internal Fixation of Patellar Fracture with Patellectomy and Soft Tissue Repair

CPT-27520-CLOSED-REDUCTION-PATELLA-FRACTURE

CPT 27520: Closed Reduction of Patella Fracture

CPT-27562-CLOSED-REDUCTION-PATELLA

CPT 27562: Closed Reduction of Dislocated Patella

CPT-27519-DISTAL-FEMORAL-EPIPHYSEAL-SEPARATION-OPEN-REDUCTION-FIXATION

CPT 27519: Open Reduction of Distal Femoral Epiphyseal Separation

CPT-27513-DISTAL-FEMUR-INTERCONDYLAR-FRACTURE-OPEN-REDUCTION

CPT 27513: Open Reduction, Distal Femur Intercondylar Fracture

CPT-27517-CLOSED-REDUCTION-DISTAL-FEMORAL-EPIPHYSEAL-SEPARATION

CPT 27517: Closed Reduction, Distal Femoral Epiphyseal Separation

CPT-27558-OPEN-REDUCTION-INTERNAL-FIXATION-KNEE-LIGAMENT-REPAIR

CPT 27558: ORIF of Dislocated Knee with Ligament Repair

CPT-27535-UNICONDYLAR-PROXIMAL-TIBIAL-PLATEAU-OPEN-REDUCTION-INTERNAL-FIXATION

CPT 27535: ORIF of Unicondylar Proximal Tibial Plateau Fracture

Showing 1–10 of 30

`50`	Bilateral procedure	Use if both knees undergo the same open reduction/patellectomy during the same operative session.
`62`	Two surgeons	Use when two surgeons of different specialties perform distinct portions of the procedure concurrently (e.g., orthopedic surgeon and microvascular surgeon if complex reconstruction needed).
`66`	Surgical team	Use when multiple surgeons function as a surgical team and billing reflects team surgery rules.
`52`	Reduced services	Use when the procedure is partially reduced or not completed as planned.
`53`	Discontinued procedure	Use if the procedure is started but terminated due to extenuating circumstances.
`59`	Distinct procedural service	Use to indicate a distinct separate procedure on the same day (e.g., separate arthrotomy coded separately) when appropriate.
`73`	Discontinued outpatient hospital/ASC before anesthesia	Use if procedure cancelled after preparation but before anesthesia induction in the ASC/hospital outpatient setting.
`78`	Unplanned return to OR for related procedure during the postoperative period	Use for reoperation related to the initial `27566` during the global period.
`79`	Unrelated procedure or service by same physician during postoperative period	(Note: `79` is not in the provided list; therefore `79` is not included.)
`76`	Repeat procedure by same physician	(Note: `76` is not in the provided list; therefore `76` is not included.)
`22`	Unusual procedural services	Use when work required to complete the procedure is substantially greater than typical (extensive scarring, abnormal anatomy).
`24`	Unrelated E/M during postoperative period	(Note: `24` is not in the provided list; therefore `24` is not included.)
`26`	Professional component	Use when billing only the professional component distinct from technical facility services.
`TC`	Technical component	Use when billing only the technical component (facility resources) for the procedure.
`RT`	Right side	Use to identify the right knee when side-specific reporting is required.
`LT`	Left side	Use to identify the left knee when side-specific reporting is required.

Taxonomy Code	Specialty	Notes
`207X00000X`	Orthopedic Surgery	Primary specialty performing `27566` (patellar reduction/patellectomy).
`207L00000X`	Sports Medicine (Orthopedic)	Subspecialists managing recurrent patellar instability and operative reconstruction.
`2080S00000X`	General Surgery	Rarely involved; included for completeness when general surgeons perform lower-extremity procedures in resource-limited settings.
`2086S0105X`	Hand Surgery	Not typically applicable — Data not available in the input.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`M22.0`	Recurrent dislocation of patella	Primary indication for open reduction and potential patellectomy when instability is severe and recurrent.
`S83.021A`	Dislocation of patella, right knee, initial encounter	Acute traumatic patellar dislocation often treated with reduction; may require `27566` if irreducible or with associated damage.
`S83.022A`	Dislocation of patella, left knee, initial encounter	Same as above for the left knee.
`M22.2`	Patellofemoral disorder	Includes maltracking and pain that may lead to surgical intervention when conservative care fails.
`S80.0`	Contusion of knee	Acute knee trauma that can accompany patellar dislocation and complicate management (used when present).

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`27418`	Osteotomy, tibial tubercle; medial or lateral displacement	Performed when tibial tubercle realignment is required to correct patellar maltracking in conjunction with open reduction.
`27427`	Ligamentous reconstruction (augmentation), knee; extra-articular	May be used for lateral retinacular stabilization procedures performed with patellar realignment.
`27599`	Unlisted procedure, femur or knee	Used for unusual or not otherwise specified knee procedures that accompany open patellar reduction when no specific code fits.
`27420`	Tendon transfer or transplantation, knee area	Sometimes used when extensor mechanism reconstruction is required during patellectomy or reduction.
`29875`	Arthroscopy, knee, synovectomy; major (e.g., more than 3 compartments)	Arthroscopic procedures may be performed before or after open reduction for intra-articular pathology; reported separately if done.

OpenPayer