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    OpenPayerBilling CodesRepair, Revision, and/or Reconstruction Procedures on the Leg (Tibia and Fibula) and Ankle JointCPT cpt-27715-tibia-fibula-lengthening-shortening-leg-length-correction
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    CPT 27715: Tibia and Fibula Lengthening or Shortening for Leg Length Discrepancy

    Medicare pays $1382 on average nationally for this procedure.

    CPT code 27715 describes a surgical procedure in which the provider lengthens or shortens the tibia and fibula to correct a discrepancy in leg length; this is an orthopedic reconstructive service typically performed in an operating room or ambulatory surgery center and involves bone manipulation and fixation to restore limb-length symmetry.

    For related coverage guidance, see recent payer policy updates: Implants for Joint Pain, Orthopedic Applications of Stem Cell Therapy, Bone Lengthening (Distraction Osteogenesis).

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    Clinical & Coding Specifications

    Clinical Context

    A 14-year-old adolescent male presents with a 3.5 cm limb-length discrepancy of the lower extremities following a distal femur physeal injury sustained two years prior. The patient reports progressive gait asymmetry, compensatory hip and knee pain, and difficulty with athletic activities. Preoperative evaluation includes standing long-leg radiographs, CT scan for deformity analysis, and full clinical assessment of neurovascular status and soft-tissue condition. The orthopedic surgical team (pediatric orthopedic surgeon) schedules a corrective tibial and fibular lengthening/shortening procedure under general anesthesia in an ambulatory surgery center or hospital operating room depending on anesthesia and comorbidity requirements.

    The operative workflow typically includes preoperative marking and templating, application of external fixation or intramedullary lengthening device as indicated, osteotomy of the tibia (and fibula when required), acute shortening or controlled distraction for lengthening, intraoperative fluoroscopy to confirm alignment and length correction, and closure with sterile dressing. Postoperative management includes inpatient or outpatient monitoring for pain control, neurovascular checks, guidance on weight-bearing status, physical therapy for gait training, and serial radiographs to monitor regenerate bone or consolidation. Complications monitored for include infection, nonunion, neurovascular injury, compartment syndrome, and hardware-related problems. Rehabilitation is coordinated with physical therapy and orthotics as needed for gait normalization.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    20696Lengthening, skeletal, by gradual distraction (e.g., callotasis), tibia or fibula (separate procedure)Alternative targeted code for gradual distraction techniques when reported distinctly
    27702Open treatment of tibial shaft fracture, with or without external fixation, with manipulation and/or internal fixationMay be performed if osteotomy requires fixation or when concurrent fracture fixation is necessary
    20690Application of external fixation device (e.g., for limb lengthening/temporary stabilization)Used when external fixation is applied as part of the lengthening construct
    20670Open treatment of tibial fracture with internal fixation, includes plate/screw; percutaneous techniquesRelevant when internal fixation is used after osteotomy or to stabilize the bone post-correction
    20680Removal of external fixation devicePerformed at a later date to remove external fixator used during distraction/consolidation

    Related Modifiers

    8 rows

    ModifierDescriptionWhen to Use
    50Modifier –50 (Bilateral Procedure) is appended to a CPT code when an identical procedure is performed on paired anatomical structures during the same operative session. The AMA states to add…- Use modifier -50 when the same CPT surgical, diagnostic, or radiology procedure is performed on paired anatomical structures (both sides of the body) during the same operative/session by the same…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    77Modifier 77 indicates that a previously performed procedure or service was legitimately repeated by a different physician or other qualified health care professional. The AMA’s CPT definition…- Use modifier 77 when a basic procedure or service already performed is repeated by a different physician or other qualified health care professional (for example, a second provider independently…
    59Modifier 59 indicates a distinct procedural service when two procedures that are not normally billed together are clinically and procedurally separate. The CPT definition (as reiterated by CMS)…- Use modifier -59 to report a distinct procedural service when documentation supports that the procedure reported is not normally billed together with another service on the same day because of a…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
    79Modifier 79 indicates a surgical procedure performed during the postoperative global period of a prior surgery that is unrelated to the original procedure. Per AMA/CPT and CMS guidance, it is…- Use modifier 79 when the same physician (or same‑specialty physician in the same group) performs a surgical procedure during the postoperative global period of a prior surgery and the new procedure…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    207P00000X
    2080P0207X
    208VP0000X
    208600000X
    363L00000X
    363LA2100X
    207ZP0104X
    2471C3402X

    Related ICD-10-CM Codes

    8 rows

    ICD-10-CM CodeDescription
    M84.372AStress fracture, left ankle, initial encounter for fracture
    M84.373AStress fracture, unspecified ankle, initial encounter for fracture
    M84.374AStress fracture, right foot, initial encounter for fracture
    M84.376AStress fracture, unspecified foot, initial encounter for fracture
    Q67.0Congenital facial asymmetry
    S72.001AFracture of unspecified part of neck of right femur, initial encounter for closed fracture
    S82.101AUnspecified fracture of upper end of right tibia, initial encounter for closed fracture
    S82.201AUnspecified fracture of shaft of right tibia, initial encounter for closed fracture

    Related Payer Policy Updates

    Specialty: Orthopedics/Musculoskeletal1 / 3

    10 rows

    PolicyPayerEffective Date
    Implants for Joint PainBlue Cross Blue Shield - Rhode Island2027-03-01
    Orthopedic Applications of Stem Cell TherapyBlue Cross Blue Shield - Rhode Island2027-01-01
    Bone Lengthening (Distraction Osteogenesis)Blue Cross Blue Shield - North Dakota2027-01-01
    Orthopedic Joint Procedures of the Knee for Managed Medicaid (MMC), Health and Recovery Plan (HARP), Child Health Plus (CHP), and Essential Plan (EP) Membersuniverahealthcare2027-01-01
    Sacroiliac Joint Fusion for the Treatment of Adult Low-Back Pain Medical PolicyHealth-New-England2026-12-01
    Bone Grafts and Stabilization Devices for Spinal Defects - Medical PolicyHealth-New-England2026-12-01
    Implantable Shock Absorbers for Treatment of Knee Osteoarthritisblue cross blue shield - louisiana2026-12-01
    Autologous Chondrocyte Transplantation or Implantation Corporate Medical Policybcbsvermont2026-12-01
    Cartilage Implants for Joint Painpremerabluecrossofwashington2026-11-06
    Cartilage Implants for Joint Painpremerabluecrossofwashington2026-11-06

    Related Codes

    CPT-27650-ACHILLES-TENDON-PRIMARY-REPAIR

    CPT 27650: Primary Repair of Achilles Tendon Tear

    CPT-27652-ACHILLES-TENDON-REPAIR-WITH-GRAFT

    CPT 27652: Achilles Tendon Repair with Graft

    CPT-27654-ACHILLES-TENDON-REPAIR-REPEAT-REVISION

    CPT 27654: Repair of Achilles Tendon, Revision

    CPT-27656-LEG-FASCIA-RECONSTRUCTION-REPAIR

    CPT 27656: Repair of Leg Fascia

    CPT-27658-FLEXOR-TENDON-REPAIR-LEG-PRIMARY

    CPT 27658: Primary Repair of Flexor Tendon(s) of Leg

    CPT-27659-FLEXOR-TENDON-REPAIR-LEG-REVISION

    CPT 27659: Repair of Flexor Tendons of the Leg (Revision)

    CPT-27664-EXTENSOR-TENDON-REPAIR-LEG-PRIMARY-REPAIR-NO-GRAFT

    CPT 27664: Primary Repair of Extensor Tendon of Leg without Graft

    CPT-27665-EXTENSOR-TENDON-REPAIR-LEG-REVISION

    CPT 27665: Repair of Extensor Tendon(s) of Leg, Revision

    CPT-27675-PERONEAL-TENDON-REPAIR-DISLOCATION

    CPT 27675: Repair of Dislocated Peroneal Tendons Without Fibular Osteotomy

    CPT-27676-PERONEAL-TENDON-STABILIZATION-FIBULAR-GROOVE

    CPT 27676: Peroneal Tendon Repair with Fibular Groove Creation

    Showing 1–10 of 42

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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