Loading...

    Explore
    • Policy Monitoring
    • Live Policy Feed
    • Billing Codes
    • NPI Medicare & Medicaid
    • Healthcare Providers
    • Health Insurance Payers
    • States
    • Service Lines
    • Taxonomy Codes
    Lookup tools
    • Billing Code Lookup
    • CPT Modifier Lookup
    • Provider Taxonomy Code Lookup
    • Healthcare Provider & Facility Lookup
    • Health Insurance Payer Lookup
    • Payer Contact Directory

    Policy & Benchmark Tools

    • Prior Authorization Lookup
    • Coverage Criteria Lookup
    • Timely Filing Lookup
    • Billing Code Reimbursement Rates
    • Payer Comparison Dashboard
    • Facility Comparison Dashboard
    • All tools

    Company

    • About OpenPayer
    • Data Sources
    • Trek Health
    OpenPayerby Trek Health
    LinkedInYouTube

    © 2026 Trek Health. All rights reserved.

    OpenPayer is built and maintained by Trek Health.

    v1.0.28
    OpenPayerBilling CodesRepair, Revision, and/or Reconstruction Procedures on the Leg (Tibia and Fibula) and Ankle JointCPT cpt-27745-tibial-internal-fixation-augmentation
    Ask Trek AI about this page

    CPT 27745: Tibial Stabilization with Internal Fixation and Bone Cement

    Medicare pays $692 on average nationally for this procedure.

    CPT code 27745 describes surgical stabilization of a weakened tibia using internal fixation (nails, pins, plates, or wires) with optional bone cement such as methylmethacrylate to reinforce bone at risk for fracture; this is an orthopedic operative procedure for patients with bone disease (for example osteoporosis or benign/malignant neoplasm) and is typically performed in an inpatient or outpatient surgical setting such as an operating room or ambulatory surgery center.

    For related coverage guidance, see recent payer policy updates: Hip Arthroplasty (partial and total hip replacement), Shoulder Arthroplasty (Total, Partial, Reverse, Revision and Resurfacing), Artificial Lumbar Intervertebral Disc (Lumbar Total Disc Arthroplasty).

    Customize your policy alerts

    Sign up for cpt 27745 policy alerts

    Get alerted when payer policies referencing 27745 are released or updated.

    Monitor payer policy activity

    Receive email alerts as soon as relevant payer policies are published or updated.

    Table of contents

    Progress1 / 6

    Explore openpayer tools

    • Billing CodesCPT, HCPCS, DRG & more
    • Reimbursement RatesCommercial vs. Medicare rate reports
    • ProvidersHospitals & facilities
    • PayersPlans & market footprint
    • Taxonomy CodesNUCC specialty codes
    • ModifiersCPT modifiers & usage
    • Prior AuthorizationPA policies by payer & drug
    • Timely FilingFiling deadlines by payer
    • Coverage CriteriaMedical necessity by payer
    • Payer ContactsClaims, PA & appeals contacts
    View all tools

    Clinical & Coding Specifications

    Clinical Context

    A 72-year-old female patient with long-standing osteoporosis presents with progressive right proximal tibial pain and radiographic evidence of a pathological impending fracture through a lytic lesion. The orthopedic surgeon evaluates risks of imminent collapse and elects to perform internal fixation with intramedullary nails and supplemental polymethylmethacrylate bone cement augmentation to stabilize the tibia and prevent fracture. The clinical workflow includes preoperative imaging (plain radiographs and CT or MRI as indicated), medical clearance, informed consent that documents the indication (bone disease with risk of fracture), perioperative prophylactic antibiotics, intraoperative fluoroscopic guidance for hardware placement and cement delivery, postoperative radiographs to confirm implant position and cement fill, and routine follow-up for wound check and rehabilitation.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    20680Removal of implant; deep (e.g., buried wire, pin, screw, metal band, rod or other fixation device)May be performed at a later date if hardware removal is indicated after healing or if hardware-related complications occur.
    70190Computed tomography, tibia/fibula; without contrastPreoperative advanced imaging to define lesion extent and plan fixation and cement augmentation.
    73630Radiologic examination, tibia and fibula; complete, minimum of two viewsPreoperative and postoperative plain radiographs to document fracture risk, hardware placement, and cement fill.
    20930Allograft, morselized, or placement of osteobiologic materialUsed when supplemental graft material or bone substitute is placed in conjunction with fixation and cementing.
    20690Application of external fixation system (injury or deformity)Alternative stabilization method when internal fixation with nails/plates is not feasible; may be used before or after definitive internal fixation in complex cases.
    99223Initial hospital care, per day, for evaluation and management of a patient, typically 70 minutesRepresentative inpatient evaluation and management code for patients requiring hospital admission for the procedure and immediate postoperative care.

    Related Modifiers

    12 rows

    ModifierDescriptionWhen to Use
    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…
    23Modifier -23 (Unusual Anesthesia) is used on anesthesia service CPT codes when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia…- Use modifier -23 only on anesthesia CPT codes (00100–01999) when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia because of…
    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…
    51Modifier –51 (Multiple Procedures) is used when the same provider performs multiple procedures in the same session to identify secondary, non‑exempt procedures and indicate payment reduction logic…- Use modifier -51 when the same provider performs multiple distinct procedures during the same patient encounter: report the highest‑valued procedure first (no modifier) and append -51 to…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    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…
    58Modifier 58 (Staged or related procedure/service by the same physician during the postoperative period) indicates that a subsequent procedure performed by the same provider during the…- Use modifier 58 when the same physician/QHP performs a procedure during the postoperative/global period of an earlier procedure and the subsequent procedure is either planned or anticipated…
    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…
    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…
    76Modifier -76, Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional, is appended when the same provider performs an identical, medically necessary procedure or…- Use modifier -76 when the same physician or other qualified health care professional performs an identical procedure or service a second (or subsequent) time on the same date of service and the…

    Showing 1–10 of 12

    Related Provider Taxonomies

    8 rows

    Taxonomy CodeSpecialtyNotes
    207L00000XAnesthesiology PhysicianAn anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an opera…
    207V00000XObstetrics & Gynecology PhysicianAn obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproducti…
    207K00000XAllergy & Immunology PhysicianAn allergist-immunologist is trained in evaluation, physical and laboratory diagnosis, and management of disorders involving the immune system. Select…
    305S00000XPoint of ServiceThis product may also be called an open-ended HMO and offers a transition product incorporating features of both HMOs and PPOs. Beneficiaries are enro…
    173F00000XSleep Specialist (PhD)Sleep medicine is a clinical specialty with a focus on clinical problems that require accurate diagnosis and treatment. The knowledge base of sleep me…
    246ZE0600XElectroneurodiagnostic Specialist/TechnologistTechnologists, Technicians & Other Technical Service Providers · Specialist/Technologist, Other
    156FC0801XContact Lens FitterAn optician or other ancillary support staff person who, where authorized by state law and trained or certified to do so, may fit or dispense contact …
    287300000XDeactivated - Christian Science SanitoriumInactive, use 282J00000X

    Related Payer Policy Updates

    Specialty: Orthopedics/Musculoskeletal1 / 3

    7 rows

    PolicyPayerEffective Date
    Hip Arthroplasty (partial and total hip replacement)univerahealthcare2026-10-15
    Shoulder Arthroplasty (Total, Partial, Reverse, Revision and Resurfacing)univerahealthcare2026-10-15
    Artificial Lumbar Intervertebral Disc (Lumbar Total Disc Arthroplasty)univerahealthcare2026-10-15
    Metal-on-Metal Total Hip Resurfacinguniverahealthcare2026-10-15
    Lumbar Fusion (arthrodesis) with decompressionuniverahealthcare2026-10-15
    Osteochondral Grafting of the Kneeuniverahealthcare2026-10-15
    Sacroiliac Joint Fusion or Stabilizationuniverahealthcare2026-10-15

    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.
    Published by

    Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.