Summary & Overview
CPT 27637: Excision of Tibia or Fibula Bone Cyst with Autograft Repair
CPT code 27637 designates surgical excision of a bone cyst or benign tumor from the tibia or fibula with repair of the defect using an autograft. This orthopedic procedure addresses symptomatic or structurally significant benign lesions of the lower leg and can prevent pathologic fracture, correct deformity, and restore structural integrity. Nationally, it is relevant to hospitals, ambulatory surgical centers, and orthopedic surgeons managing benign bone lesions.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical framing of the procedure, typical sites of service, and the common billing context for this code. The publication outlines benchmark considerations and policy-relevant points for national payers, highlights clinical indications and procedural components that underlie coding choices, and summarizes common modifier usage and billing nuances when available.
This summary prepares administrators, coders, and clinicians to understand the clinical intent of CPT code 27637, expected care settings, and the payer landscape relevant to authorization, claims submission, and documentation standards. Data not available in the input is noted where applicable in the detailed sections.
Billing Code Overview
CPT code 27637 describes the surgical removal of a bone cyst or benign tumor from the tibia or fibula with repair of the resulting defect using an autograft. This procedure is an orthopedic surgical intervention focused on excision of a benign osseous lesion in the lower leg and reconstruction of the bone using the patient's own bone graft material.
Service type: Surgical — orthopedic tumor/cyst excision with autograft repair
Typical site of service: Hospital inpatient or outpatient surgical facility / Ambulatory surgery center, depending on lesion size, patient factors, and surgeon decision.
Clinical & Coding Specifications
Clinical Context
A typical patient is an adolescent or young adult who presents with focal tibial pain, swelling, or pathologic fracture after minimal trauma. Imaging (plain radiographs and MRI or CT) demonstrates a benign bone cyst or benign osseous tumor in the tibia or fibula. The orthopedic surgeon schedules an operative procedure to perform curettage of the lesion, obtain tissue for pathology, and reconstruct the resulting defect with an autograft (often harvested from the ipsilateral iliac crest or local bone). The procedure is usually performed in an ambulatory surgical center or hospital operating room under general or regional anesthesia. Preoperative workflow includes history and physical, informed consent specifying autograft harvest, preoperative imaging review, and perioperative antibiotic prophylaxis. Intraoperative steps include lesion localization, incision and exposure, aggressive curettage or en bloc removal as indicated, autograft harvest and packing of the defect, possible internal fixation if structural support is needed, hemostasis, and layered closure. Postoperative care involves pain control, wound care, weight-bearing restrictions based on defect size and fixation, and outpatient follow-up with radiographic surveillance.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when billing only the physician’s professional component separate from technical component (rare for this surgical service). |