CPT 27756 Percutaneous Tibial Fixation Reimbursement | OpenPayer

Summary & Overview

CPT 27756: Percutaneous Fixation of Tibial Shaft Fracture

CPT code 27756 denotes percutaneous fixation of a tibial shaft fracture with pins or screws placed through the skin into bone. This procedure stabilizes the tibial fracture to maintain alignment, prevent displacement during healing, and reduce pain, while explicitly not addressing any associated fibular fracture. Nationally, the code is relevant across acute orthopedic trauma care settings, including hospital operating rooms and ambulatory surgery centers. Its use influences procedural classification, facility and professional billing, and case-mix considerations.

Key payers in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of clinical context for the procedure, typical sites of service, and what to expect in billing practice. The publication summarizes common modifier usage and payer coverage patterns where available, benchmarks for utilization and reimbursement where present, and policy considerations that can affect authorization and claims adjudication. The content is intended to support coding teams, revenue cycle managers, and clinical leaders seeking a concise reference on how CPT code 27756 is described and applied in practice. Data not available in the input are noted where applicable.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare27756CPTorthopedic-surgerytibial-fracturepercutaneous-fixationtraumaoperative-procedureambulatory-surgery

Billing Code Overview

CPT code 27756 describes percutaneous fixation of a tibial shaft fracture using pins or screws placed through the skin into the bone. The procedure is performed to maintain alignment, prevent displacement during healing, and relieve pain. The description specifies that a fibular fracture, if present, is not treated as part of this procedure.

Service type: Percutaneous internal fixation of tibial shaft fracture
Typical site of service: Operative setting such as an ambulatory surgery center or hospital operating room

Clinical & Coding Specifications

Clinical Context

A typical patient is an adult who sustained an isolated closed transverse or short oblique fracture of the tibial shaft after a fall or low-energy trauma. The patient presents to the emergency department with acute pain, swelling, and inability to weight-bear on the affected leg. Radiographs confirm a displaced tibial shaft fracture without a clinically significant fibular fracture requiring fixation. The orthopedic surgeon performs percutaneous fixation using pins or screws placed through the skin into the tibia (closed reduction percutaneous pin fixation) under regional or general anesthesia in an operating room or procedure suite. The goals are fracture alignment, stabilization to prevent displacement during healing, and acute pain control. Typical workflow includes preoperative imaging and consent, regional or general anesthesia, closed reduction under fluoroscopic guidance, percutaneous placement of pins or screws across the fracture site, wound dressing and immobilization (splint or cast), postoperative radiographs, neurovascular checks, and discharge with outpatient follow-up for wound check and progressive weight-bearing as indicated.

Coding Specifications

Modifier	Description	When to Use
`LT`	Left side	Use when the procedure is performed on the left tibia.
`RT`

CPT 27788: Closed Manipulation of Distal Fibula Fracture

CPT-27823-TRIMALLEOLAR-ANKLE-FIXATION-ORIF

CPT 27823: Trimalleolar Ankle Fixation (ORIF)

CPT-27846-OPEN-REDUCTION-ANKLE-DISLOCATION-WITH-FIXATION

CPT 27846: Open Reduction of Ankle Dislocation with Fixation

CPT-27759-TIBIAL-SHAFT-INTRAMEDULLARY-NAILING

CPT 27759: Tibial Shaft Intramedullary Nailing

CPT-27766-MEDIAL-MALLEOLUS-OPEN-FIXATION-PLATES-SCREWS

CPT 27766: Open Fixation of Medial Malleolus Fracture

CPT-27825-DISTAL-TIBIA-CLOSED-REDUCTION-SKELETAL-TRACTION

CPT 27825: Closed Reduction of Distal Tibia Fracture with Skeletal Traction

CPT-27792-DISTAL-FIBULA-FRACTURE-FIXATION-OPEN-REDUCTION-INTERNAL-FIXATION

CPT 27792: ORIF of Distal Fibula Fracture

CPT-27826-DISTAL-TIBIA-FIBULAR-FIXATION-OPEN-REDUCTION-INTERNAL-FIXATION

CPT 27826: Open Fixation of Distal Tibia with Fibular Stabilization

CPT-27814-BIMALLEOLAR-ANKLE-FRACTURE-FIXATION-OPEN-REDUCTION-INTERNAL-FIXATION

CPT 27814: Open Reduction and Internal Fixation of Two Malleoli

CPT-27842-CLOSED-TREATMENT-ANKLE-DISLOCATION-ANESTHESIA

CPT 27842: Closed Treatment of Ankle Dislocation with Anesthesia

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Taxonomy Code	Specialty	Notes
207X00000X	Orthopedic Surgery	Most common specialty performing tibial shaft fixation.
2080P0207X	Orthopedic Trauma Surgery	Subspecialists managing complex long-bone fractures.
2086S0126X	General Surgery — Trauma	Trauma surgeons in mixed trauma centers who may perform urgent fixation.
362L00000X	Podiatry	Rarely involved for select distal tibial/pilon adjacent procedures; usually not primary for tibial shaft.
208000000X	Emergency Medicine	May perform initial closed reductions in ED but not definitive percutaneous fixation in most systems.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`S82.201A`	Unspecified fracture of shaft of right tibia, initial encounter for closed fracture	Common code for closed tibial shaft fracture on the right side treated with percutaneous fixation.
`S82.202A`	Unspecified fracture of shaft of left tibia, initial encounter for closed fracture	Same as above for left-sided injuries.
`S82.211A`	Displaced fracture of shaft of right tibia, initial encounter for closed fracture	Displaced tibial shaft fractures frequently require fixation to maintain alignment.
`S82.212A`	Displaced fracture of shaft of left tibia, initial encounter for closed fracture	Left-sided displaced tibial shaft fracture indication for surgical stabilization.
`S82.221A`	Undisplaced fracture of shaft of right tibia, initial encounter for closed fracture	Some undisplaced fractures may be managed nonoperatively, but percutaneous fixation is used when indicated by instability.
`S82.222A`	Undisplaced fracture of shaft of left tibia, initial encounter for closed fracture	Left-side counterpart; clinical relevance similar.
`S82.301A`	Unspecified fracture of shaft of right tibia, initial encounter for open fracture	Open fractures may require more extensive management; percutaneous fixation may be part of staged care.
`S82.302A`	Unspecified fracture of shaft of left tibia, initial encounter for open fracture	Left-side open fracture consideration for staged fixation strategies.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`27756`	Percutaneous fixation of tibial shaft fracture with pins or screws	Primary code describing closed percutaneous tibial shaft fixation.
`27758`	Open treatment of tibial shaft fracture, includes internal fixation, with or without cerclage	Used when the fracture requires open reduction and internal fixation instead of percutaneous pinning.
`20690`	Preparation and application of external fixation system (unlisted long-bone)	Applied when temporary or definitive external fixation is used for tibial fractures, often before or instead of `27756`.
`73630`	Radiologic examination, ankle; 2 or 3 views	Common perioperative imaging for distal tibial alignment checks; used adjunctively.
`73610`	Radiologic examination, tibia and fibula; 2 or 3 views	Preoperative and postoperative radiographs to document fracture alignment and fixation.
`99024`	Postoperative follow-up visit global period (minor surgical procedures)	Used by some payors for reporting routine postoperative visits during global period; may be applicable for postoperative care documentation.

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