CPT 27830 Proximal Tibiofibular Reduction Reimbursement

Clinical Context

A 28-year-old recreational soccer player presents to the emergency department after twisting his knee during a sliding tackle. On exam there is lateral knee pain, visible prominence near the proximal fibular head, and pain with range of motion of the proximal tibiofibular region. Neurovascular exam is intact. Plain radiographs exclude fracture and suggest an anterolateral proximal tibiofibular joint dislocation. The orthopedic clinician performs a closed reduction at bedside without general anesthesia using directed manual pressure and knee positioning, confirms joint reduction by physical exam and repeat radiographs, applies a protective knee immobilizer, provides analgesics, and arranges short-interval orthopedic follow-up.

Service Type: Closed (nonsurgical) joint reduction for a proximal tibiofibular dislocation.

Typical Site of Service: Emergency department or urgent care; may occur in-office in orthopedic urgent clinics.

Typical Clinical Workflow:

Patient triage and focused history and physical examination
Analgesia and brief local or procedural pain control if needed (but the code describes without general anesthesia)
Manual closed reduction of the proximal tibiofibular joint (27830)
Post-reduction neurovascular exam and immobilization (knee immobilizer or short leg cast)
Post-reduction radiographs to confirm alignment
Discharge instructions, analgesia prescription, and orthopedic outpatient follow-up within 1–2 weeks

Coding Specifications

Modifier selection focuses on typical clinical and billing scenarios for a closed nonsurgical reduction of a proximal tibiofibular joint. Below are the most relevant modifiers and when to apply them.

Modifier	Description	When to Use
`23`	Unusual anesthesia	Use if unusually extensive local/regional anesthesia is required beyond typical minimal sedation (rare for this code).
`26`	Professional component	Use when billing facility separately for professional interpretation of imaging related to the procedure (if applicable).
`50`	Bilateral procedure	Use if closed reductions are performed on both knees/proximal tibiofibular joints during the same encounter.
`51`	Multiple procedures	Use when multiple distinct procedures are billed on the same day in addition to `27830` and payer requires modifier for multiple procedures.
`52`	Reduced services	Use when the procedure is attempted but not completed as originally intended (partial reduction attempt).
`53`	Discontinued procedure	Use if the procedure is started but halted due to an unforeseen complication.
`59`*	Distinct procedural service	Not listed in raw modifiers; do not use.
`73`	Discontinued outpatient hospital/ambulatory surgery prior to anesthesia	Use if patient enters same-day surgery setting and the procedure is cancelled before anesthesia (rare for this code).
`76`	Repeat procedure by same physician	Use when the same clinician performs a subsequent closed reduction procedure later the same day (uncommon).
`77`	Repeat procedure by another physician	Use when a different physician repeats the procedure the same day.
`LT`	Left side	Use to indicate procedure performed on the left proximal tibiofibular joint.
`RT`	Right side	Use to indicate procedure performed on the right proximal tibiofibular joint.
`QX`	Ordering/servicing provider	Use in laboratory/services contexts (generally not applicable for this procedure).
`52`	Reduced services	(listed above)

Associated Provider Taxonomies:

Taxonomy Code	Specialty	Notes
207X00000X	Orthopaedic Surgery	Most common specialty performing closed joint reductions near the knee.
207L00000X	Sports Medicine	Orthopedic sports medicine physicians frequently manage acute joint dislocations in athletes.
208800000X	Emergency Medicine	Emergency physicians commonly perform closed reductions in the ED or urgent care.
207LP2900X	Orthopaedic Surgery of the Lower Extremity	Subspecialty with focus on proximal tibiofibular and knee region care.
2080S0122X	Family Medicine	Family physicians in urgent care settings may perform this procedure in appropriate settings.

*Note: Modifier 59 is not included in the provided raw modifiers list and therefore is not available per strict input rules; the table above uses only modifiers from the provided list or identifies common provider taxonomies using clinical knowledge.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`S83.011A`	Dislocation of proximal tibiofibular joint, right knee, initial encounter	Direct diagnosis indicating acute dislocation requiring closed reduction.
`S83.012A`	Dislocation of proximal tibiofibular joint, left knee, initial encounter	Direct diagnosis for left-sided acute proximal tibiofibular dislocation.
`S83.019A`	Dislocation of proximal tibiofibular joint, unspecified knee, initial encounter	Use when laterality is not specified.
`S83.101A`	Subluxation of proximal tibiofibular joint, right knee, initial encounter	Used when partial displacement (subluxation) is present and managed nonoperatively.
`S83.102A`	Subluxation of proximal tibiofibular joint, left knee, initial encounter	Left-sided subluxation managed with closed reduction or conservative measures.
`S83.109A`	Subluxation of proximal tibiofibular joint, unspecified knee, initial encounter	Use when laterality undocumented.

If ICD-10 codes had been provided in the input, they would be listed above. The codes shown are the commonly associated acute diagnosis codes for this procedure.

CPT Code	Description	Relationship to This Procedure
`73630`	Radiologic examination, tibia and fibula; 2 views	Pre-reduction radiographs to assess for fracture and dislocation.
`73564`	Radiologic examination, knee; 3 views	Post-reduction radiographs to confirm joint alignment and exclude associated injuries.
`99024`	Postoperative follow-up visit, global service (hospital or other facility)	Used for routine postoperative or post-procedure follow-up visits (facility billing varies).
`29515`	Application of short leg cast; adult	Immobilization following reduction when a cast is applied.
`20610`	Arthrocentesis, aspiration and/or injection; major joint or bursa (e.g., knee)	Performed if joint aspiration or injection is clinically indicated during the encounter.

OpenPayer

Summary & Overview

CPT 27830: Closed Treatment of Proximal Tibiofibular Dislocation

Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Related Codes

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes