Summary & Overview
CPT 27745: Tibial Internal Fixation and Augmentation
CPT code 27745 covers surgical internal fixation and augmentation of a weakened tibial segment using nails, pins, plates, and/or wires, and may include bone cement such as methylmethacrylate. This code is used when the procedure is undertaken to stabilize bone weakened by conditions like osteoporosis or benign or malignant neoplasms. Nationally, procedures coded with 27745 are relevant to orthopedic surgical capacity, perioperative care pathways, and payer coverage policies for complex bone disease management.
Key payers referenced include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical context for when 27745 is reported, typical settings of care (operating room, ambulatory surgical center, or inpatient hospital), and the procedural intent of fixation and augmentation. The publication provides benchmarks for utilization patterns where available, summarizes relevant policy and coverage considerations at the national level, and outlines implications for surgical coding accuracy and documentation. Data not available in the input is noted explicitly where applicable, and clinical scenarios that commonly trigger use of this code are described to support billing and administrative decision-making.
Billing Code Overview
CPT code 27745 describes a surgical procedure to strengthen a weakened area of the tibia using internal fixation devices such as nails, pins, plates, and/or wires. The procedure may include the application of bone cement (for example, methylmethacrylate) and is performed for underlying bone disease conditions such as osteoporosis or benign or malignant bone neoplasm.
Service type: Surgical — Orthopedic internal fixation/augmentation of tibia
Typical site of service: Operating room or ambulatory surgical center, with inpatient hospital admission possible depending on the patient's condition and complexity.
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.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier / default | Use when no other modifier applies and standard reporting is required. |
11 | Professional component (or default) | Use when reporting the usual service; applies when the surgeon performs and bills the procedure without additional unusual circumstances. |