Summary & Overview
CPT 27702: Total Ankle Reconstruction with Implant
CPT code 27702 designates total ankle reconstruction with an implant (total ankle arthroplasty) performed to relieve severe pain from end-stage arthritis or fracture-related joint destruction. This major reconstructive procedure has national significance due to its clinical complexity, impact on mobility and quality of life, and implications for hospital and surgical specialist resource use. Key payers typically involved in coverage and reimbursement decisions include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical context for CPT code 27702, payer coverage considerations, and the types of benchmarks and policy updates commonly reviewed around major joint replacement procedures. The publication summarizes expected sites of service, common billing modifiers provided in the input, and typical clinical scenarios that lead to use of this code. It also highlights relevant areas for operational attention, such as settings of care, potential authorization needs, and documentation focus for medical necessity. Data not available in the input is noted where applicable; the primary aim is to provide clear, nationally relevant context for coding, billing, and policy discussions related to total ankle arthroplasty under CPT code 27702.
Billing Code Overview
CPT code 27702 describes a surgical procedure in which the provider reconstructs the total ankle joint using an implant to treat severe pain caused by conditions such as advanced arthritis or post-traumatic damage from fractures. This procedure is a form of total ankle arthroplasty.
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Service type: Surgical reconstruction of the ankle joint with implant (total ankle replacement)
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Typical site of service: Inpatient hospital or ambulatory surgery center, depending on clinical complexity and payer requirements
Clinical & Coding Specifications
Clinical Context
A 68-year-old patient with end-stage post-traumatic osteoarthritis of the ankle presents with severe pain, instability, and marked functional limitation despite conservative therapy (NSAIDs, orthotics, corticosteroid injections, and physical therapy). Imaging shows advanced joint space collapse, subchondral sclerosis, and talar or tibial deformity. The orthopedic foot and ankle surgeon schedules a total ankle arthroplasty to reconstruct the tibiotalar joint using a prosthetic implant to relieve pain and restore ankle alignment and motion. Typical workflow: preoperative evaluation and medical optimization in clinic; preauthorization with payors; preop anesthesia clearance and templating; intraoperative general or regional anesthesia with implant insertion (CPT 27702) in an ambulatory surgery center or hospital operating room; immediate postoperative recovery with neurovascular checks and pain control; discharge with weight-bearing instructions and early physical therapy; routine postoperative follow-up for wound checks, radiographs, and progressive rehabilitation.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
RT | Right side | Use when the procedure is performed on the right ankle. |
LT |