Summary & Overview
CPT 27780: Long Leg Cast for Proximal or Shaft Fibula Fracture
CPT code 27780 denotes application of a long leg cast for fractures of the proximal fibula or fibular shaft. This immobilization procedure is commonly used to stabilize lower-leg fractures and manage pain while promoting bone healing. Nationally, casts remain a widely used, low-complexity intervention that affects orthopedics, emergency medicine, and ambulatory surgery workflows and billing practices.
Key payers covered in this overview include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the clinical context for use of CPT code 27780, typical sites of service where the procedure is performed, and the types of information normally included in billing and coverage analyses. The publication outlines common billing considerations, expected service lines, and related documentation elements relevant to claims processing and payer adjudication.
This summary provides operational context for clinicians, coding staff, and revenue cycle professionals seeking clarity on when CPT code 27780 applies and what coverage stakeholders typically review. Data not available in the input will be identified where applicable in the full publication.
Billing Code Overview
CPT code 27780 describes the application of a long leg cast for treatment of a fracture of the proximal fibula or the shaft of the fibula. This procedure is a form of immobilization intended to stabilize the lower leg and ankle by extending the cast from the thigh to the foot.
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Service type: Cast application / closed treatment immobilization
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Typical site of service: Hospital inpatient, hospital outpatient, emergency department, or ambulatory surgical center depending on clinical setting and patient acuity.
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Clinical & Coding Specifications
Clinical Context
A 34-year-old male presents to the emergency department after a high-energy ankle inversion injury sustained during a soccer match. He reports immediate lateral leg pain and swelling and is unable to bear weight. Emergency department clinicians obtain ankle and lower leg radiographs that confirm a displaced fracture of the proximal fibular shaft without tibial involvement. The orthopedic on-call provider evaluates the patient, documents neurovascular status and skin integrity, provides analgesia, and determines that initial immobilization in a long leg cast is appropriate prior to definitive outpatient follow-up or operative fixation.
Clinical workflow: The patient is triaged and imaged, the orthopedic provider performs a focused exam and documents indication (fracture of the proximal fibula), informed consent for immobilization is obtained, and a cast technician or orthopedic clinician applies a long leg cast (CPT 27780) in the ED or ambulatory orthopedics clinic. Post-application neurovascular check documentation and cast care instructions are provided. Radiographs are repeated as needed to confirm alignment and plan definitive treatment.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
25 |