Summary & Overview
CPT 27580: Knee Arthrodesis (Knee Joint Fusion)
CPT code 27580 defines surgical arthrodesis (fusion) of the knee joint and is applied when joint preservation is untenable due to infection, failed total knee arthroplasty, loss of quadriceps function, congenital femoral dysgenesis, or similar severe conditions. Nationally, this procedure is an important, though infrequent, option for limb salvage and pain control in complex orthopedic cases and carries implications for surgical resource use, postacute care, and long-term functional outcomes.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical intent and typical service settings, benchmarking context relative to major payers, and policy-relevant details that affect authorization, coverage pathways, and site-of-service considerations. The publication provides a clinical-context summary, common billing modifiers and administrative notes (where available), and guidance on topics readers frequently seek about coding, documentation, and payer interactions for complex knee fusion cases.
Data not available in the input for specific line-item benchmarks, associated taxonomies, and ICD-10 mappings.
Billing Code Overview
CPT code 27580 describes arthrodesis or fusion of the knee joint, performed by the provider using any technique. This procedure is used to create a stable, pain-free knee by surgically fusing the femur and tibia when joint preservation is not feasible.
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Service type: Surgical orthopedics — knee arthrodesis/fusion
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Typical site of service: Inpatient or outpatient hospital surgical setting; may also be performed in ambulatory surgery centers depending on clinical complexity and institutional capability.
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Clinical & Coding Specifications
Clinical Context
A 68-year-old male with a long-standing history of right total knee arthroplasty presents with chronic pain, deep periprosthetic infection confirmed by aspiration culture, and radiographic loosening of the prosthesis. The patient has marked instability and loss of effective quadriceps mechanism. After failed attempts at irrigation and debridement and a staged revision, the orthopedic surgeon schedules a knee arthrodesis to address persistent infection and restore a stable, pain-free limb capable of weightbearing.
The clinical workflow includes preoperative optimization (infection control, medical clearance, informed consent), intraoperative removal of any remaining hardware and infected tissue, preparation of joint surfaces, and fixation using an intramedullary rod or plate with bone graft as needed to achieve fusion. Perioperative antibiotics are administered based on cultures. Postoperative care includes immobilization, pain control, DVT prophylaxis, wound surveillance, and progressive weightbearing guided by radiographic evidence of fusion. Typical admission is to an inpatient hospital or specialized orthopedic surgical center with expected extended recovery and outpatient follow-up for radiographic checks and rehabilitation.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
11 | Provider is the usual or primary surgeon | Use when the reporting surgeon performed the primary portion of the arthrodesis. |