Summary & Overview
CPT 27647: Hindfoot Tumor Resection, Talus or Calcaneus
CPT code 27647 designates surgical resection of a tumor with wide margins from the talus or calcaneus, a procedure used to treat serious conditions such as chronic osteomyelitis or bone cancer of the hindfoot. This code captures high-complexity orthopedic oncology work often performed in hospital operating rooms or ambulatory surgical centers and has implications for surgical billing, care coordination, and post-operative management.
Key payers in national analyses include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of the clinical context for the code, common billing and service-line considerations, and benchmarking and policy-relevant topics that affect coverage and payment practices. The publication summarizes typical sites of service, procedural intent (tumor excision with wide margins), and areas where documentation and coding specificity are important for payers and providers.
The content addresses clinical indications, expected care settings, and the administrative footprint surrounding CPT code 27647. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 27647 describes removal of a tumor with wide margins from the talus or calcaneus. The procedure is performed for conditions such as severe chronic osteomyelitis or bone malignancy affecting the hindfoot.
-
Service type: Surgical oncology / orthopedic tumor resection
-
Typical site of service: Hospital operating room or ambulatory surgical center, depending on clinical complexity and patient status
Clinical & Coding Specifications
Clinical Context
A 58-year-old male with a long-standing history of uncontrolled diabetes and peripheral vascular disease presents with persistent drainage and pain of the heel despite prolonged antibiotic therapy and multiple debridements. Imaging demonstrates osteomyelitic involvement of the calcaneus with sequestrum formation and surrounding cortical destruction. The orthopedic oncology team elects to perform a partial calcanectomy with wide margins to remove infected and necrotic bone and achieve source control. The patient is admitted to an inpatient surgical unit, receives preoperative evaluation including vascular and infectious disease consultation, perioperative IV antibiotics, and surgical planning for possible soft-tissue reconstruction. Intraoperatively, the surgeon performs resection of the involved calcaneus with wide margins, obtains bone cultures and pathology specimens, and documents the extent of resection. Postoperative care includes wound monitoring, IV antibiotics guided by culture results, pain control, vascular assessments, and physical therapy planning for protected weight-bearing and possible orthotic or reconstructive follow-up visits.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | Unspecified | Rarely used; only when a specific modifier is not applicable and payer allows unspecified modifier usage. |