This info listed to assist Dr. W. with coding procedures.
Leg (Tibia and Fibula) and Ankle Joint (27600-27899)
Incision (27600-27612)
27600 Decompression fasciotomy, leg; anterior and/or lateral compartments only
27601 Decompression fasciotomy, leg; posterior compartment(s) only
27602 Decompression fasciotomy, leg; anterior and/or lateral, and posterior compartment(s)
(For incision and drainage procedures, superficial, see 10040 10060 10061 10080 10081 10120 10121 10140 -10160)
(For decompression fasciotomy with debridement, see 27892 27893 -27894)
27603 Incision and drainage, leg or ankle; deep abscess or hematoma
27604 Incision and drainage, leg or ankle; infected bursa
27605 Tenotomy, percutaneous, Achilles tendon (separate procedure); local anesthesia
27606 Tenotomy, percutaneous, Achilles tendon (separate procedure); general anesthesia
27607 Incision (eg, osteomyelitis or bone abscess), leg or ankle
27610 Arthrotomy, ankle, including exploration, drainage, or removal of foreign body
27612 Arthrotomy, posterior capsular release, ankle, with or without Achilles tendon lengthening
(See also 27685)
Excision (27613-27647)
27613 Biopsy, soft tissue of leg or ankle area; superficial
27614 Biopsy, soft tissue of leg or ankle area; deep (subfascial or intramuscular)
(For needle biopsy of soft tissue, use 20206)
27615 Radical resection of tumor (eg, malignant neoplasm), soft tissue of leg or ankle area
27618 Excision, tumor, leg or ankle area; subcutaneous tissue
27619 Excision, tumor, leg or ankle area; deep (subfascial or intramuscular)
27620 Arthrotomy, ankle, with joint exploration, with or without biopsy, with or without removal of loose or foreign body
27625 Arthrotomy, with synovectomy, ankle;
27626 Arthrotomy, with synovectomy, ankle; including tenosynovectomy
(for case with peroneal tenosynovectomy, as suggested Jan ’14 by Wendy Holloway: Look at codes 27625 and 26. These codes could potentially be used when I have done an arthrotomy for lateral ankle recon, esp if ankle instability was present. There is no specific CPT for exploration and debridement, but these codes have a dx of synovitis appended to each and 27626 is not bundled/inclusive to 27698)
27630 Excision of lesion of tendon sheath or capsule (eg, cyst or ganglion), leg and/or ankle
27635 Excision or curettage of bone cyst or benign tumor, tibia or fibula;
27637 Excision or curettage of bone cyst or benign tumor, tibia or fibula; with autograft (includes obtaining graft)
27638 Excision or curettage of bone cyst or benign tumor, tibia or fibula; with allograft
27640 Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, osteomyelitis or exostosis); tibia
27641 Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, osteomyelitis or exostosis); fibula
27645 Radical resection of tumor, bone; tibia
27646 Radical resection of tumor, bone; fibula
27647 Radical resection of tumor, bone; talus or calcaneus
Introduction or Removal (27648-27648)
27648 Injection procedure for ankle arthrography
(For radiological supervision and interpretation, use 73615. Do not report 76003 in addition to 73615)
(For ankle arthroscopy, see 29894 29895 29897 -29898)
Repair, Revision, and/or Reconstruction (27650-27745)
27650 Repair, primary, open or percutaneous, ruptured Achilles tendon;
27652 Repair, primary, open or percutaneous, ruptured Achilles tendon; with graft (includes obtaining graft)
27654 Repair, secondary, Achilles tendon, with or without graft
27656 Repair, fascial defect of leg
27658 Repair, flexor tendon, leg; primary, without graft, each tendon (also per Wendy Holloway Dec ’13 this code is used for peroneal tendon repair)
27659 Repair, flexor tendon, leg; secondary, with or without graft, each tendon
27664 Repair, extensor tendon, leg; primary, without graft, each tendon
27665 Repair, extensor tendon, leg; secondary, with or without graft, each tendon
27675 Repair, dislocating peroneal tendons; without fibular osteotomy
27676 Repair, dislocating peroneal tendons; with fibular osteotomy
27680 Tenolysis, flexor or extensor tendon, leg and/or ankle; single, each tendon
27681 Tenolysis, flexor or extensor tendon, leg and/or ankle; multiple tendons (through separate incision(s))
27685 Lengthening or shortening of tendon, leg or ankle; single tendon (separate procedure)
27686 Lengthening or shortening of tendon, leg or ankle; multiple tendons (through same incision), each
27687 Gastrocnemius recession (eg, Strayer procedure)
(Toe extensors are considered as a group to be a single tendon when transplanted into midfoot)
27690 Transfer or transplant of single tendon (with muscle redirection or rerouting); superficial (eg, anterior tibial extensors into midfoot)
27691 Transfer or transplant of single tendon (with muscle redirection or rerouting); deep (eg, anterior tibial or posterior tibial through interosseous space, flexor digitorum longus, flexor hallicus longus, or peroneal tendon to midfoot or hindfoot)
27692 Transfer or transplant of single tendon (with muscle redirection or rerouting); each additional tendon (List separately in addition to code for primary procedure)
(Use 27692 in conjunction with codes 27690, 27691)
27695 Repair, primary, disrupted ligament, ankle; collateral
27696 Repair, primary, disrupted ligament, ankle; both collateral ligaments
27698 Repair, secondary disrupted ligament, ankle, collateral (eg, Watson-Jones procedure)
27700 Arthroplasty, ankle;
27702 Arthroplasty, ankle; with implant (total ankle)
27703 Arthroplasty, ankle; revision, total ankle
27704 Removal of ankle implant
27705 Osteotomy; tibia
27707 Osteotomy; fibula
27709 Osteotomy; tibia and fibula
27712 Osteotomy; multiple, with realignment on intramedullary rod (eg, Sofield type procedure)
(For osteotomy to correct genu varus (bowleg) or genu valgus (knock-knee), see 27455 -27457)
27715 Osteoplasty, tibia and fibula, lengthening or shortening
27720 Repair of nonunion or malunion, tibia; without graft, (eg, compression technique)
27722 Repair of nonunion or malunion, tibia; with sliding graft
27724 Repair of nonunion or malunion, tibia; with iliac or other autograft (includes obtaining graft)
27725 Repair of nonunion or malunion, tibia; by synostosis, with fibula, any method
27727 Repair of congenital pseudarthrosis, tibia
27730 Arrest, epiphyseal (epiphysiodesis), open; distal tibia
27732 Arrest, epiphyseal (epiphysiodesis), open; distal fibula
27734 Arrest, epiphyseal (epiphysiodesis), open; distal tibia and fibula
27740 Arrest, epiphyseal (epiphysiodesis), any method, combined, proximal and distal tibia and fibula;
27742 Arrest, epiphyseal (epiphysiodesis), any method, combined, proximal and distal tibia and fibula; and distal femur
(For epiphyseal arrest of proximal tibia and fibula, see 27477)
27745 Prophylactic treatment (nailing, pinning, plating or wiring) with or without methylmethacrylate, tibia
Fracture and/or Dislocation (27750-27848)
27750 Closed treatment of tibial shaft fracture (with or without fibular fracture); without manipulation
27752 Closed treatment of tibial shaft fracture (with or without fibular fracture); with manipulation, with or without skeletal traction
27756 Percutaneous skeletal fixation of tibial shaft fracture (with or without fibular fracture) (eg, pins or screws)
27758 Open treatment of tibial shaft fracture, (with or without fibular fracture) with plate/screws, with or without cerclage
27759 Treatment of tibial shaft fracture (with or without fibular fracture) by intramedullary implant, with or without interlocking screws and/or cerclage
27760 Closed treatment of medial malleolus fracture; without manipulation
27762 Closed treatment of medial malleolus fracture; with manipulation, with or without skin or skeletal traction
27766 Open treatment of medial malleolus fracture, with or without internal or external fixation
27767 Closed treatment of posterior malleolus fracture without manipulation
27768 Closed treatment of posterior malleolus fracture with manipulation
27769 Open treatment of posterior malleolus fracture, includes internal fixation when performed
27780 Closed treatment of proximal fibula or shaft fracture; without manipulation
27781 Closed treatment of proximal fibula or shaft fracture; with manipulation
27784 Open treatment of proximal fibula or shaft fracture, with or without internal or external fixation
27786 Closed treatment of distal fibular fracture (lateral malleolus); without manipulation
27788 Closed treatment of distal fibular fracture (lateral malleolus); with manipulation
27792 Open treatment of distal fibular fracture (lateral malleolus), with or without internal or external fixation
27808 Closed treatment of bimalleolar ankle fracture, (including Potts); without manipulation
27810 Closed treatment of bimalleolar ankle fracture, (including Potts); with manipulation
27814 Open treatment of bimalleolar ankle fracture, with or without internal or external fixation
27816 Closed treatment of trimalleolar ankle fracture; without manipulation
27818 Closed treatment of trimalleolar ankle fracture; with manipulation
27822 Open treatment of trimalleolar ankle fracture, with or without internal or external fixation, medial and/or lateral malleolus; without fixation of posterior lip
27823 Open treatment of trimalleolar ankle fracture, with or without internal or external fixation, medial and/or lateral malleolus; with fixation of posterior lip
27824 Closed treatment of fracture of weight bearing articular portion of distal tibia (eg, pilon or tibial plafond), with or without anesthesia; without manipulation
27825 Closed treatment of fracture of weight bearing articular portion of distal tibia (eg, pilon or tibial plafond), with or without anesthesia; with skeletal traction and/or requiring manipulation
27826 Open treatment of fracture of weight bearing articular surface/portion of distal tibia (eg, pilon or tibial plafond), with internal or external fixation; of fibula only
27827 Open treatment of fracture of weight bearing articular surface/portion of distal tibia (eg, pilon or tibial plafond), with internal or external fixation; of tibia only
27828 Open treatment of fracture of weight bearing articular surface/portion of distal tibia (eg, pilon or tibial plafond), with internal or external fixation; of both tibia and fibula
27829 Open treatment of distal tibiofibular joint (syndesmosis) disruption, with or without internal or external fixation
27830 Closed treatment of proximal tibiofibular joint dislocation; without anesthesia
27831 Closed treatment of proximal tibiofibular joint dislocation; requiring anesthesia
27832 Open treatment of proximal tibiofibular joint dislocation, with or without internal or external fixation, or with excision of proximal fibula
27840 Closed treatment of ankle dislocation; without anesthesia
27842 Closed treatment of ankle dislocation; requiring anesthesia, with or without percutaneous skeletal fixation
27846 Open treatment of ankle dislocation, with or without percutaneous skeletal fixation; without repair or internal fixation
27848 Open treatment of ankle dislocation, with or without percutaneous skeletal fixation; with repair or internal or external fixation
Manipulation (27860-27860)
27860 Manipulation of ankle under general anesthesia (includes application of traction or other fixation apparatus)
Arthrodesis (27870-27871)
27870 Arthrodesis, ankle, open
(For arthroscopic ankle arthrodesis, use 29899)
27871 Arthrodesis, tibiofibular joint, proximal or distal
Amputation (27880-27889)
27880 Amputation, leg, through tibia and fibula;
27881 Amputation, leg, through tibia and fibula; with immediate fitting technique including application of first cast
27882 Amputation, leg, through tibia and fibula; open, circular (guillotine)
27884 Amputation, leg, through tibia and fibula; secondary closure or scar revision
27886 Amputation, leg, through tibia and fibula; re-amputation
27888 Amputation, ankle, through malleoli of tibia and fibula (eg, Syme, Pirogoff type procedures), with plastic closure and resection of nerves
27889 Ankle disarticulation
Other Procedures (27892-27899)
27892 Decompression fasciotomy, leg; anterior and/or lateral compartments only, with debridement of nonviable muscle and/or nerve
(For decompression fasciotomy of the leg without debridement, see 27600)
27893 Decompression fasciotomy, leg; posterior compartment(s) only, with debridement of nonviable muscle and/or nerve
(For decompression fasciotomy of the leg without debridement, see 27601)
27894 Decompression fasciotomy, leg; anterior and/or lateral, and posterior compartment(s), with debridement of nonviable muscle and/or nerve
(For decompression fasciotomy of the leg without debridement, see 27602)
27899 Unlisted procedure, leg or ankle
