Summary & Overview
CPT 27742: Tibial/Fibular and Distal Femur Growth Modulation (Epiphysiodesis)
CPT code 27742 denotes an orthopedic surgical epiphysiodesis in which the end plates of the upper and lower tibia and fibula and the lower femur are fused to interrupt growth and equalize leg length during the patient’s growth period. The code represents a targeted, growth-modulating operative technique used primarily in pediatric and adolescent orthopedic practice to manage limb length discrepancies and prevent progressive deformity.
Key national payers included in the analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical description, the typical sites of service, and payer coverage context. The publication provides benchmarks for utilization and reimbursement patterns where available, summarizes relevant policy considerations and prior-authorization trends, and situates the procedure within clinical pathways for limb length discrepancy management.
The report is intended for clinicians, coding and billing professionals, and managed care policy staff seeking a clear, national-level reference for CPT code 27742, including coding intent, care setting, and the types of coverage policies and utilization issues that commonly arise for growth modulation procedures.
Billing Code Overview
CPT code 27742 describes a surgical growth modulation procedure in which the provider fuses the end plates of the upper and lower tibia and fibula and the lower femur to interrupt their growth. The procedure is performed to stop further longitudinal growth of the tibia, fibula, and lower femur on the treated side so that limb lengths can be equalized during the patient’s growth phase.
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Service type: Surgical orthopedic growth modulation / epiphysiodesis
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Typical site of service: Inpatient or outpatient surgical setting (hospital operating room or ambulatory surgery center)
Clinical & Coding Specifications
Clinical Context
A typical patient is a pediatric or adolescent with progressive lower‑extremity limb-length discrepancy during the growth phase. The patient presents with a measurable difference in leg length (often 2 cm or greater) confirmed by standing radiographs and clinical exam demonstrating gait asymmetry or compensatory pelvic tilt. After evaluation by a pediatric orthopedic surgeon, growth modulation via temporary epiphysiodesis is planned to arrest growth of the longer limb(s). The procedure involves surgical fusion of the distal femoral and/or proximal tibial physes (and occasionally proximal fibular physis) to slow longitudinal growth and allow the contralateral limb to catch up over time.
The clinical workflow includes preoperative imaging and measurement (standing long-leg alignment films), informed consent and counseling about timing relative to skeletal maturity, preoperative clearance, and scheduling. Intraoperatively, the surgeon performs guided physeal arrest using open or percutaneous techniques, implants hardware if indicated, and confirms placement with fluoroscopy. Postoperative care includes outpatient recovery, wound checks, activity restrictions, follow-up radiographs at regular intervals to monitor limb-length equalization, and eventual hardware removal if temporary devices were used.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | (Placeholder - not a standard CMS modifier) | Data not standard; avoid use unless payer-specific guidance requires it. |