CPT® Code 27724

The procedure described by CPT® Code 27724 involves the surgical repair of a nonunion or malunion of the tibia, utilizing an autograft, which is a graft taken from the patient's own body. A nonunion occurs when the fracture fragments fail to heal together after an adequate period, while a malunion refers to a situation where the fragments heal in an incorrect position, leading to potential complications such as bone deformities, joint incongruities, soft tissue issues, and nerve entrapment. The surgical approach begins with exposing the original fracture site in the tibia to assess the condition of the nonunion or malunion. This evaluation is crucial in determining the appropriate repair method. Unlike other procedures that may use internal fixation alone, as seen in CPT® Code 27720, or a sliding bone graft as in CPT® Code 27722, the 27724 code specifically incorporates the use of a bone graft to fill the defect and promote healing. The process includes harvesting a bone autograft, typically from the iliac crest, which involves making an incision over the iliac crest, stripping the muscle to access the bone, and obtaining either cortical or cancellous bone. This harvested bone is then shaped to fit the defect in the tibia, or it may be morcellized and packed into the area needing repair. Internal fixation devices, such as pins or wires, may be employed to secure the graft in place, and additional stabilization is provided using a compression plate and screws. This comprehensive approach aims to restore proper alignment and stability to the tibia, facilitating the healing process and improving the overall function of the limb.