CPT® Code 27457

Osteotomy, proximal tibia, including fibular excision or osteotomy (includes correction of genu varus [bowleg] or genu valgus [knock-knee]); after epiphyseal closure

An osteotomy of the proximal tibia is a surgical procedure that involves cutting and reshaping the upper part of the tibia, which is the larger bone in the lower leg. This procedure may also include the excision or cutting of a portion of the fibula, the smaller bone located alongside the tibia. The primary purpose of this surgery is to correct deformities of the knee, specifically genu varus, commonly known as bowleg, and genu valgus, referred to as knock-knee. The choice of the specific type of osteotomy performed, such as transverse, wedge, sliding, right or left angle, V-osteotomy, or Z-osteotomy, is determined by the nature and location of the deformity. Prior to the surgery, the physician utilizes radiographic studies to accurately plan the site and configuration of the bone cut to achieve optimal alignment and correction. During the procedure, an incision is made over the lower leg, allowing for dissection of the soft tissues to expose the tibia and fibula. The periosteum, a layer of tissue covering the bone, is elevated to facilitate access. The bone is then cut using specialized instruments, and if necessary, a portion of the fibula is removed or an osteotomy is performed on it as well. Bone grafts may be placed between the cut segments to promote healing and stability. To secure the bones in their new position, various internal fixation devices such as pins, screws, or plates may be used, or alternatively, an external fixation device may be applied. It is important to note that this specific code, CPT® 27457, is utilized when the procedure is performed after the epiphyseal closure, indicating that the patient's bone growth has been completed.