CPT® Code 27454

Osteotomy, multiple, with realignment on intramedullary rod, femoral shaft (CPT® Code 27454) refers to a surgical procedure that involves making multiple cuts in the femur, which is the long bone in the thigh, to correct deformities or to realign the bone structure. This procedure is particularly relevant in cases where the femur has developed a deformity that affects its function or alignment. The specific type and location of the osteotomies performed are tailored to the individual patient's needs, depending on the nature and site of the deformity. Various techniques may be employed, including transverse, wedge, sliding, right or left angle, V-osteotomy, and Z-osteotomy, each chosen based on the specific anatomical and pathological considerations. Prior to the surgical intervention, the physician utilizes radiographic studies to precisely determine the locations for the bone cuts, ensuring that the surgical approach is well-planned. The procedure typically begins with a longitudinal incision over the femoral shaft, followed by careful dissection of the soft tissues to expose the femur. The periosteum, a dense layer of connective tissue surrounding the bone, is elevated to allow access to the bone itself. The surgeon then employs tools such as drills, saws, and osteotomes to create the necessary bone cuts in the predetermined configuration. After the osteotomies are made, an appropriately sized intramedullary rod is selected to provide internal stabilization. This rod is inserted into the intramedullary canal of the femur, which is drilled or reamed to accommodate the rod. If a cannulated rod is utilized, a guidewire is first placed into the canal to facilitate the rod's placement. Once the rod is positioned correctly, the bone is realigned at each osteotomy site, and the rod is secured in place using screws, pins, or other fixation devices, ensuring stability and proper healing of the femur.