Summary & Overview
CPT 27604: Drainage of Deep Leg or Ankle Bursa Infection
CPT code 27604 represents surgical drainage of a deep infected bursa in the lower leg or ankle — a targeted procedure to evacuate pus, treat localized infection, and relieve pain. This code is clinically important for acute musculoskeletal infection management and has implications for surgical billing, infection-control pathways, and utilization monitoring across national payers.
Key payers included in the analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of typical clinical indications and site-of-service considerations, national billing benchmarks where available, and contextual policy notes that affect coding and reimbursement for surgical drainage of deep lower-extremity bursae.
The publication outlines expected service settings (hospital or ambulatory surgical center), common clinical context for the procedure, and where to look for related coding guidance. Data limitations are noted when specific payer fee schedules or utilization metrics are not available. The content is written for national stakeholders including clinicians, practice managers, and payer contracting teams who need concise, actionable details about CPT code 27604 and its place in surgical infection management workflows.
Billing Code Overview
CPT code 27604 describes an open drainage procedure for an infected bursa located deep within the lower leg or around the ankle. The procedure is performed to evacuate purulent material, treat infection, and relieve pain by providing direct access to the infected bursal space.
Service type: Surgical drainage of deep lower extremity bursal infection
Typical site of service: Hospital operating room or ambulatory surgical center, or other inpatient/outpatient surgical settings where deep drainage and management of infection are performed.
Clinical & Coding Specifications
Clinical Context
A 48-year-old male presents to the emergency department with progressive swelling, erythema, and intense pain over the posterior aspect of the ankle for 48 hours. He has fever of 101.8°F, elevated white blood cell count, and focal fluctuance on exam consistent with a deep infected retrocalcaneal bursa. After bedside ultrasound confirms a localized fluid collection deep to the Achilles tendon sheath and aspiration yields purulent fluid, the orthopedic surgeon schedules an urgent procedural drainage. In the operating room under regional block or general anesthesia the provider performs an open incision and drainage of the infected bursa, irrigates the cavity, obtains cultures, and places a drain if needed. The procedure is documented as 27604 (Drainage of infected bursa, deep, leg or ankle) with laterality and any applicable modifier for professional or technical components, anesthesia, or post-op circumstances. Typical workflow includes pre-procedure consent and cultures, operative drainage, post-procedure antibiotic therapy guided by culture results, wound care instructions, and documentation of findings, amount and character of purulent material, and whether a drain was placed. Typical site of service is the operating room, ambulatory surgery center, or emergency department procedure room depending on acuity and anesthesia needs. Service type: surgical drainage procedure for infection control and pain relief.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
25 |