Summary & Overview
CPT 27827: Open Reduction, Internal Fixation of Distal Tibia Fracture
CPT code 27827 denotes open reduction and internal fixation of fractures involving the weight-bearing articular surface or portion of the distal tibia using plates, screws, wires, or pins. This operative code captures definitive surgical management for distal tibial (pilon or plafond) fractures that disrupt the ankle joint surface and thus has implications for postoperative care, rehabilitation, and prosthesis-sparing outcomes. Nationally, fixation of intra-articular distal tibia fractures represents a clinically significant portion of lower-extremity trauma care due to risks of post-traumatic arthritis and the need for specialized orthopedic surgical resources.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context and expected sites of service, along with benchmarks for billing and utilization where available. The publication summarizes typical coding uses, common service settings, and payer considerations relevant to surgical repair of weight-bearing distal tibial fractures. It also highlights areas where policy updates or payer coverage rules commonly affect authorization, surgical setting decisions, and post-acute management. Data not available in the input will be noted explicitly in supporting sections.
Billing Code Overview
CPT code 27827 describes a surgical procedure to repair a fracture of the weight-bearing articular surface or a portion of the distal tibia by securing the tibia with plates and screws, wires, or pins. This procedure involves open internal fixation of distal tibial fractures that affect the joint-bearing surface.
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Service type: Surgical fracture fixation (open reduction and internal fixation)
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Typical site of service: Hospital inpatient or outpatient operating room, and ambulatory surgical center when appropriate
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult who sustained a distal tibial fracture involving the weight‑bearing articular surface after a high‑energy mechanism such as a fall from height, motor vehicle collision, or sports injury. The patient presents to the emergency department with pain, swelling, deformity, and inability to bear weight. Initial evaluation includes neurovascular exam, plain radiographs (AP, lateral, mortise views), and often CT to define articular involvement.
Definitive management for displaced intra‑articular fractures of the distal tibia often requires open reduction and internal fixation. The operative workflow includes preoperative consent and medical optimization, regional or general anesthesia, intraoperative fluoroscopy, exposure of the distal tibia, anatomic reduction of the articular surface, fixation with plates and screws (and sometimes supplemental wires or pins), wound closure, and postoperative immobilization. Typical postoperative care includes pain control, DVT prophylaxis, nonweightbearing or protected weightbearing for a period determined by fixation stability and healing, and scheduled follow‑up with serial radiographs and physical therapy as indicated.
Typical site of service is an inpatient or ambulatory surgery center (ASC) depending on patient comorbidities and injury severity. The service type is surgical orthopaedic repair of a distal tibial articular fracture using internal fixation.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
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