Summary & Overview
CPT 27607: Excision of Leg or Ankle Bone Abscess for Osteomyelitis
CPT code 27607 denotes an open surgical excision of a bone abscess in the leg or ankle to treat osteomyelitis. The code represents a targeted operative intervention for established bone infection and is used in billing for definitive surgical management when debridement and abscess removal are required. Nationally, accurate coding for procedures addressing osteomyelitis affects hospital surgical case mix, reimbursement, and quality measurement around infection management.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of clinical context for the procedure, typical sites of service, and which payers commonly reimburse for this type of surgical service. The publication summarizes benchmarking context, common billing considerations, and relevant policy or coverage themes that influence utilization and payment for operative management of osteomyelitis.
This summary prepares clinical coders, billing managers, and policy analysts to understand where CPT code 27607 fits within surgical service lines, how it is used for inpatient and outpatient reporting, and what to expect from major national payers in terms of coverage patterns and policy drivers. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 27607 describes a surgical procedure in which the provider makes an incision in the leg or ankle and excises a bone abscess to treat osteomyelitis. This is an open operative procedure focused on removing infected bone and purulent material to control or eradicate bone infection.
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Service type: Surgical debridement/excision for osteomyelitis
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Typical site of service: Hospital operating room or ambulatory surgical center, with post-operative inpatient or outpatient follow-up as clinically indicated
Clinical & Coding Specifications
Clinical Context
A 56-year-old male with poorly controlled diabetes presents with chronic draining sinus and persistent forefoot pain despite prolonged antibiotics. Imaging (MRI) demonstrates cortical destruction and a focal collection within the distal tibia consistent with chronic osteomyelitis and a subperiosteal abscess. The orthopedic surgeon schedules operative debridement with incision and excision of the bone abscess under general anesthesia. The preoperative workflow includes history and physical, updated diabetic management, surgical consent, perioperative antibiotics, and operative cultures. Intraoperatively, the surgeon makes an incision over the affected distal tibia/ankle, performs cortical windowing, evacuates purulent material, excises necrotic bone until viable bleeding bone is encountered, obtains bone and tissue cultures and sends specimens to the lab, and places dressings or drains as indicated. Postoperative care includes wound care, targeted IV antibiotics guided by culture results, pain management, glycemic control, and outpatient orthopedic follow-up for wound check and possible further reconstruction.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
LT | Left side | Use when the procedure is performed on the left lower extremity |
RT |