CPT 27601 Posterior Compartment Fasciotomy Reimbursement | OpenPayer

Summary & Overview

CPT 27601: Posterior Compartment Fasciotomy of the Leg

CPT code 27601 denotes a surgical decompression fasciotomy of the posterior compartment of the leg, performed to relieve compartment pressure, reduce pain, and restore perfusion. Nationally, this code captures care for acute or chronic compartment syndromes and related ischemic or pressure-related conditions needing surgical release. Accurate coding is important for clinical documentation, appropriate site-of-service reporting, and claims processing for invasive extremity procedures.

Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of typical clinical indications and settings for the procedure, common claim modifiers used with this code, and guidance on where to locate applicable diagnosis links and related surgical codes. The publication discusses national patterns in utilization and reimbursement context for extremity fasciotomy procedures, highlights documentation elements that support medical necessity, and points to resources for payer-specific coverage and billing rules.

This summary is intended for clinicians, coding professionals, and billing analysts seeking a concise reference to the clinical purpose and administrative considerations tied to CPT code 27601 in a national context.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare27601CPTfasciotomycompartment syndromeleg surgeryorthopedic surgerysurgical procedureoperating roomambulatory surgery

Billing Code Overview

CPT code 27601 describes a decompression fasciotomy of the posterior compartment of the leg. The procedure is performed to reduce pain, relieve compartmental pressure, and improve blood flow in the affected compartment.

Service type: Surgical procedure — extremity compartment decompression
Typical site of service: Hospital operating room or ambulatory surgery center (inpatient or outpatient surgical setting)

Data not available in the input for associated taxonomies, ICD-10 diagnoses, and related codes.

Clinical & Coding Specifications

Clinical Context

A typical patient is an adult presenting to the emergency department or orthopedic clinic with acute, severe posterior compartment pain, tense swelling of the calf, pain with passive stretch of the toes, paresthesia, or diminished distal pulses after a tibial fracture, crush injury, reperfusion after vascular repair, or prolonged limb compression. Initial evaluation includes urgent neurovascular exam, compartment pressure measurement when diagnosis is uncertain, and imaging as indicated. When clinical or pressure criteria indicate compartment syndrome of the posterior compartment of the leg, an orthopedic or vascular surgeon performs a decompressive fasciotomy (CPT 27601) of the posterior compartment to relieve intracompartmental pressure, restore perfusion, and prevent muscle and nerve necrosis. Typical workflow: triage and resuscitation, focused history and exam, compartment pressure assessment as needed, informed consent, regional or general anesthesia, surgical decompression of the posterior compartment with fasciotomy incision(s), debridement if nonviable tissue is present, dressing or delayed primary/secondary closure, postoperative monitoring for recurrent elevated pressures, and staged wound management with possible delayed closure or skin grafting.

Coding Specifications

Modifier	Description	When to Use
`23`	Unusual anesthetic	Use when procedure is performed under general anesthesia because of extenuating circumstances in an otherwise local anesthesia case.

CPT 27610: Ankle Arthrotomy for Exploration, Drainage, or Foreign Body Removal

CPT-27602-LEG-FASCIOTOMY-COMPARTMENT-DECOMPRESSION

CPT 27602: Leg Fasciotomy for Compartment Decompression

CPT-27605-PERCUTANEOUS-ACHILLES-TENDON-INCISION

CPT 27605: Percutaneous Incision of Achilles Tendon

CPT-27603-INCISION-AND-DRAINAGE-ANKLE-LEG-ABSCESS-HEMATOMA

CPT 27603: Incision and Drainage, Ankle or Leg

CPT-27606-ACHILLES-TENDON-PERCUTANEOUS-INCISION

CPT 27606: Percutaneous Achilles Tendon Incision

CPT-27604-DRAINAGE-DEEP-LEG-ANKLE-BURSA-INFECTION

CPT 27604: Drainage of Deep Leg or Ankle Bursa Infection

CPT-27607-LEG-ANKLE-BONE-ABSCESS-EXCISION-OSTEOMYELITIS

CPT 27607: Excision of Leg or Ankle Bone Abscess for Osteomyelitis

CPT-27600-LEG-FASCIOTOMY-ANTERIOR-LATERAL-COMPARTMENT-DECOMPRESSION

CPT 27600: Decompression Fasciotomy of Anterior and Lateral Leg Compartments

CPT-27612-ANKLE-POSTERIOR-CAPSULOTOMY-EQUINUS-CORRECTION

CPT 27612: Posterior Capsulotomy of Ankle for Equinus Deformity

Taxonomy Code	Specialty	Notes
207P00000X	Orthopaedic Surgery	Orthopedic trauma surgeons commonly perform lower extremity fasciotomies.
2080P0208X	General Surgery	Acute compartment decompression may be performed by general surgeons in trauma settings.
2084P0802X	Vascular Surgery	Vascular surgeons perform fasciotomy when compartment syndrome follows revascularization.
207L00000X	Emergency Medicine	Emergency physicians often facilitate diagnosis and initial management and may perform emergent fasciotomy in some settings.
207K00000X	Plastic Surgery	Plastic surgeons may be involved for complex wound management and delayed closure or grafting.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`S82.201A`	Unspecified fracture of shaft of tibia, right leg, initial encounter for closed fracture	Tibial shaft fractures are a common cause of acute posterior compartment syndrome requiring fasciotomy.
`S82.202A`	Unspecified fracture of shaft of tibia, left leg, initial encounter for closed fracture	Same relevance for left-sided tibial fractures.
`T79.A11A`	Traumatic compartment syndrome of right lower limb, initial encounter	Direct diagnosis indicating compartment syndrome of the lower extremity necessitating fasciotomy.
`T79.A12A`	Traumatic compartment syndrome of left lower limb, initial encounter	Corresponding code for the left lower limb compartment syndrome.
`S89.011A`	Laceration with foreign body of right lower leg, initial encounter	Severe soft-tissue injuries and crush mechanisms can precipitate compartment syndrome.
`I97.610`	Postprocedural compartment syndrome of right lower limb	Used when compartment syndrome develops after revascularization or other procedures.
`I97.611`	Postprocedural compartment syndrome of left lower limb	Same as above for left limb.
`M79.601`	Pain in right leg, unspecified	Symptom code that may be present during evaluation; not a definitive primary diagnosis for fasciotomy but documents symptomatology.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`12001`	Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities; 2.5 cm or less	May be used for immediate wound closure of small fasciotomy incisions when appropriate.
`11043`	Debridement, subcutaneous tissue (includes epidermis and dermis, if performed); first 20 sq cm or less	Used when debridement of devitalized tissue is required during fasciotomy or in subsequent wound care.
`15002`	Adjacent tissue transfer or rearrangement, trunk; first 30 sq cm or less	Applicable for staged soft-tissue reconstruction following fasciotomy when primary closure is not possible.
`11045`	Debridement, muscle and/or fascia; first 20 sq cm or less	Used when deeper debridement of nonviable muscle or fascia is necessary during limb salvage.
`15734`	Muscle, myocutaneous, or fasciocutaneous flap; trunk	Used in reconstructive procedures after fasciotomy for coverage of large defects.
`73610`	Radiologic examination, lower extremity, ankle and foot; complete, 3 views	Imaging used preoperatively or postoperatively to evaluate fractures or hardware related to the compartment syndrome.

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