Summary & Overview
CPT 27641: Fibula Resection for Osteomyelitis
CPT code 27641 represents surgical removal of a portion of the fibula to treat osteomyelitis, performed by excising a segment or scooping out infected bone to create a saucer-like defect. This code is relevant nationally as it documents operative management of long-bone infection and drives procedural coding, billing, and quality tracking for orthopedic and podiatric surgical services. Key payers addressed in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical context for the procedure, typical sites of service, and which payers are commonly involved. The publication summarizes billing considerations and commonly applied modifiers (listed separately), outlines the clinical scenario prompting use of the code, and indicates areas where data was not provided. This brief aims to help coding clinicians, revenue-cycle staff, and policy analysts understand the clinical intent of CPT code 27641, the payer landscape, and what elements to expect in related documentation and claims. Data not available in the input is clearly noted where applicable.
Billing Code Overview
CPT code 27641 describes a surgical procedure in which a portion of the fibula is removed to treat osteomyelitis. The provider removes diseased bone either by excising a middle segment of the fibula or by scooping out infected bone, leaving a saucer-like or crater-like depression at the site.
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Service type: Surgical debridement/resection of fibula for infection
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Typical site of service: Operating room or surgical suite, often in an inpatient or ambulatory surgical center setting depending on clinical severity and patient needs
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A typical patient is a 56-year-old male with chronic osteomyelitis of the distal fibula after a contaminated ankle fracture that failed conservative measures. The patient presents with persistent localized pain, erythema, drainage from a sinus tract near the lateral malleolus, elevated inflammatory markers, and imaging (plain radiographs and MRI) demonstrating focal sequestrum and cortical bone destruction of the mid to distal fibula.
Care is coordinated by an orthopedic trauma or foot and ankle surgeon with an infectious disease consultant. Initial management includes wound culture, targeted intravenous antibiotics, and surgical planning. In the operating room under regional or general anesthesia, the surgeon exposes the fibula, identifies necrotic bone, performs a saucerization or partial resection of the diseased fibular segment to remove sequestra and infected cortical bone, achieves hemostasis, and may place local antibiotic beads or deliver bone graft if indicated. Postoperative care includes wound monitoring, continued culture-directed antibiotics, non–weight-bearing or protected weight-bearing as ordered, and outpatient infectious disease follow-up. Typical site of service is an ambulatory surgery center or hospital operating room. Service type: surgical debridement/partial bone resection (operative procedure) for chronic osteomyelitis of the fibula.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when work or complexity substantially exceeds typical for (document rationale). |