Complete Guide to Orthopedic CPT Codes for 2026

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Orthopedic billing relies heavily on medical coding, and a single incorrect procedural CPT code can lead to denials. From evaluation and diagnosis to fracture care, arthroscopy, spinal procedures, and joint replacements, each treatment has a unique CPT code. Each code must be supported by proper documentation, clean medical notes, and modifiers (if applicable) to prevent denials and rejections.

In today’s blog, we explain orthopedic CPT codes in detail, including new, revised, and deleted codes, along with ICD-10 codes, modifiers, and documentation requirements to help you keep the billing process smooth.

What are Orthopedic CPT Codes?

The American Medical Association (AMA) establishes and maintains Current Procedural Terminology (CPT) codes each year to ensure providers receive accurate reimbursements, avoid underpayments and overpayments, and stay compliant.

Orthopedic CPT codes indicate the treatment or procedure provided to improve a patient’s health. These codes help insurers understand the service or treatment provided and reimburse accordingly.

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Quick Overview of Common Orthopedic CPT Codes

Here’s a quick overview of common orthopedic CPT codes and their descriptions so that you can use the appropriate code for the treatment provided.

Orthopedic CPT Codes	Descriptions
20610	Major joint injection to inject a drug for therapeutic purposes.
29881	Knee arthroscopy of the medial or lateral compartment.
29888	Knee arthroscopy for anterior cruciate ligament (ACL) repair.
29827	Shoulder arthroscopy for rotator cuff tear repair.
23412	Open surgical repair of a chronic or persistent rotator cuff tear in the shoulder.
27130	Hip joint replacement with prosthesis, or artificial joint to replace the femoral head.
27447	Replacement of damaged surfaces of medial and lateral compartments in the knee.
27486	Revision arthroplasty of the knee joint to remove the prosthesis and insert a new one.
27245	Surgical treatment of femoral fracture by using an intramedullary implant.
27506	Femoral shaft fracture fixation.
20936	Autograft for spinal surgery.
22840	Spinal instrumentation placement in the neck to correct a spinal deformity.
63030	Lumbar laminotomy/discectomy.
64415	Anesthetic agents or steroid injections into the brachial plexus area.
77002	Fluoroscopic guidance for biopsy, aspiration, injection, or localization to identify a lesion in the body, except the spine.
73562	Knee X-ray (3 views).
72100	Lumbar spine X-ray (2–3 views).

Orthopedic CPT Codes by Procedure Category

Learn about orthopedic CPT codes by procedure category in detail, help your billers and coders assign the most appropriate one to reduce denials, and pass claims on the first attempt.

Evaluation & Management (E/M) CPT Codes

Evaluation and management CPT codes are categorized by patient type. Old/established patients and new patients.

New orthopedic patient E/M service CPT codes range from 99202 to 99205.

Old/established orthopedic patient E/M service CPT codes range from 99212 to 99215.

CPT Code	Descriptions
99202	Straightforward medical decision-making; spend 15 or more minutes on a single encounter.
99203	Low level of medical decision-making; spend 30 or more minutes on a single encounter.
99204	Moderate level of medical decision-making; spend 45 or more minutes on a single encounter.
99205	High level of medical decision-making; spend 60 or more minutes on a single encounter.
99212	Straightforward medical decision-making; spend 10 or more minutes on a single encounter.
99213	Low level of medical decision-making; spend 20 or more minutes on a single encounter.
99214	Moderate level of medical decision-making; spend 30 or more minutes on a single encounter.
99215	High level of medical decision-making; spend 40 or more minutes on a single encounter.

Fracture Care CPT Codes

Fracture care CPT codes range from 27197 to 27269, which indicate dislocation or fracture procedures on the pelvis and hip joint. CPT codes 25500 to 25695 indicate fracture or dislocation procedures on the forearm and wrists.

Here are some of the common ones used for billing;

CPT Code	Descriptions
25600	Closed treatment of the fractured wrist, without manipulation.
27786	Closed treatment of the distal fibular fracture, without manipulation.
23500	Closed treatment of a clavicular bone fracture, without adjustment or manipulation.
28470	Treatment of a metatarsal fracture without skin incision or manipulation.
25605	Closed treatment of the fractured wrist, with manipulation.
21315	Treatment of fractured nose bone with manipulation.
25607	Surgical treatment to repair a fracture of the lower radius (lower arm bone) by using screws, wires or pins.
27236	Open treatment of a femur neck fracture by internal fixation method, using pins, wires, or screws, as well as an artificial implant if necessary.

Arthroscopy CPT Codes

Arthroscopy CPT codes range from 29800 to 29999 and cover musculoskeletal diagnostic and surgical procedures, primarily organized by joint area, such as the knee, shoulder, and hip.

Here are some of the common ones used for billing;

CPT Code	Descriptions
29805	Shoulder joint arthroscopy for diagnosis and analysis.
29822	Minimal excision of damaged tissue in the shoulder joint during arthroscopy.
29823	Extensive excision of damaged tissue in the shoulder joint during arthroscopy.
29824	Arthroscopic Mumford procedure to remove clavicle, or collarbone.
29827	Arthroscopic treatment to repair torn rotator cuff.
29828	Arthroscopic treatment to repair unstable biceps tendon.
29870	Knee joint arthroscopy for diagnosis and analysis.
29875	Limited excision of synovial tissue during knee joint arthroscopy.
29876	Major synovectomy from two or more compartments in the knee.
29877	Reshaping the articular cartilage to repair the knee joint by trimming or shaving damaged tissue.
29862	Hip joint arthroscopy and joint repair by reshaping the articular cartilage.
29863	Limited excision of synovial tissue during the hip joint arthroscopy.

Joint Replacement CPT Codes

Joint replacement CPT codes range from 27097 to 27187 and indicate replacement of a worn-out, damaged, or diseased joint with an artificial device called a prosthesis.

Here are some of the common ones used for billing;

CPT Code	Descriptions
27130	Hip joint replacement with prosthesis, with or without using an autograft or allograft.
27132	Conversion of previous hip surgery to total hip surgery, with or without an autograft or allograft.
27134	Replacement of old implanted prosthesis with a new one.
27137	Replacement of only acetabular component of previously implanted prosthesis with a new one.
27138	Replacement of only femoral component of previously implanted prosthesis with a new one.
27447	Total knee replacement.
27446	Partial knee replacement.
27486	Revision of one component of a total knee replacement.
27487	Revision of both components of a total knee replacement.
23470	Partial shoulder joint replacement.
23472	Total shoulder joint replacement.
23616	Open treatment of proximal humerus fracture with prosthetic replacement.
24363	Total elbow joint replacement.

Spine Procedure CPT Codes

Spine procedure is a medical operation performed on the back, neck, or spinal column to treat conditions that cause chronic pain, nerve damage, spinal instability, or structural deformities.

Common CPT codes used to indicate spinal procedures include;

CPT Code	Descriptions
22551	Cervical disc removal from the front of the neck.
22630	Spinal fusion to permanently join two vertebrae.
63030	Laminotomy of one lumbar interspace, along with a partial facetectomy, foraminotomy, and/or the excision of a herniated intervertebral disc.
63047	Laminectomy, facetectomy, and foraminotomy at a single lumbar vertebral segment to correct spinal stenosis (narrowing) and decompress the spinal cord or nerve roots.
62380	Endoscopic removal of all or part of a bulging intervertebral disc.

Orthopedic Injection CPT Codes

Orthopedic injection procedures relieve pain and reduce inflammation in the joint, tendon sheath, bursa, or spinal space.

Common CPT codes used to indicate orthopedic injection procedures include;

CPT Code	Descriptions
20600	Injection to a small joint or bursa, without using ultrasound guidance.
20605	Injection to an intermediate joint or bursa without using ultrasound guidance.
20610	Injection to a major joint or bursa without using ultrasound guidance.
20604	Injection to a small joint or bursa, involving fingers or toes, using ultrasound guidance with permanent recording and reporting.
20606	Injection to an intermediate small joint or bursa, involving the temporomandibular, acromioclavicular, wrist, elbow, ankle, or olecranon bursa, using ultrasound guidance with permanent recording and reporting.
20611	Injection to an intermediate small joint or bursa, involving the shoulder, hip, knee, or subacromial bursa, using ultrasound guidance with permanent recording and reporting.

Imaging and Diagnostic CPT Codes

Orthopedic imaging and diagnostic CPT codes report diagnostic tests that help identify fractures, joint damage, bone abnormalities, and soft-tissue injuries. These include X-rays, CT scans, MRI scans, and bone density studies.

CPT Code	Imaging Type	Description
73030	X-ray	Shoulder X-ray, 2 or more views
73110	X-ray	Wrist X-ray, 3 or more views
73130	X-ray	Hand X-ray, 3 or more views
73560	X-ray	Knee X-ray, 1 or 2 views
73562	X-ray	Knee X-ray, 3 views
73564	X-ray	Knee X-ray, 4 or more views
73610	X-ray	Ankle X-ray, 3 or more views
73630	X-ray	Foot X-ray, 3 or more views
72100	X-ray	Lumbar spine X-ray, 2 or 3 views
73200	CT scan	Upper extremity CT without contrast
73700	CT scan	Lower extremity CT without contrast
73201	CT scan	Upper extremity CT with contrast
73701	CT scan	Lower extremity CT with contrast
73221	MRI	Upper extremity joint MRI without contrast
73222	MRI	Upper extremity joint MRI with contrast
73223	MRI	Upper extremity joint MRI without and with contrast
73721	MRI	Lower extremity joint MRI without contrast
73722	MRI	Lower extremity joint MRI with contrast
73723	MRI	Lower extremity joint MRI without and with contrast
76881	Ultrasound	Complete diagnostic ultrasound of a joint or other extremity structure
76882	Ultrasound	Limited diagnostic ultrasound of an extremity
77080	Bone density	DXA bone density study of the axial skeleton, such as the hips and spine

Orthopedic ICD-10 Codes and Billing Modifiers

Along with CPT procedural codes, you must use ICD-10 diagnosis codes; without the correct pairing, claims can’t be processed by health insurance companies.

Here are the common orthopedic ICD-10 codes with their descriptions;

Orthopedic ICD-10 Codes	Descriptions
M00	Pyogenic arthritis.
M02	Postinfective and reactive arthropathies.
M04	Autoinflammatory syndromes.
M05	Rheumatoid arthritis with rheumatoid factor.
M26	Dentofacial anomalies (including malocclusion).
M40	Kyphosis and lordosis.
M41	Scoliosis
M42	Spinal osteochondrosis.
M60	Myositis
M61	Calcification and ossification of muscle.
M80	Osteoporosis with current pathological fracture.
M83	Adult osteomalacia.
M84	Disorder of continuity of bone.
M95.3	Acquired deformity of neck.
M95.4	Acquired deformity of chest and rib.
M95.5	Acquired deformity of pelvis.

For orthopedic billing and coding, modifiers are essential because they add context to CPT codes, help providers achieve full reimbursement, and prevent bundling/unbundling issues.

Here are common modifiers you can use for orthopedic billing.

Modifiers	Descriptions
24	Unrelated E/M service during postoperative period.
25	Separate E/M service on the same day of service/procedure.
58	The same physician performs related procedures.
78	Unexpected return to the operating room for another treatment.
79	The same physician performs an unrelated procedure during the postoperative global period of the original surgery.
50	Bilateral procedures are performed; means on both sides of the body.
51	Multiple procedures are performed in the same session of the service.
59	Distinct procedural services are performed.
62	Two primary surgeons performed distinct parts of a single, complex surgical procedure.
RT/LT	Indicates anatomical body parts: RT for the right side and LT for the left side.

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Documentation Requirements for Orthopedic Coding

Accurate orthopedic coding requires complete medical documentation to support the diagnosis, procedure performed, medical necessity, and CPT code selection. Missing or inconsistent information can lead to claim denials, payment delays, and coding errors.

Here’s what documentation orthopedic practices should maintain for faster and more accurate reimbursements:

Patient history and physical examination, such as symptoms, pain severity, affected body part, findings, and functional limitations.
Diagnosis and medical necessity to justify the procedure.
Imaging and diagnostic reports and findings, such as X-rays, MRI, and CT scans that support diagnosis and treatment plans.
Clear identification of the right or left side when relevant to the procedure.
Details of implants, prostheses, or other devices used during surgery, when applicable.
Recovery status, follow-up assessments, treatment response, and discharge information, as applicable.

These records help demonstrate that the orthopedic service was performed and was medically necessary. Specific requirements vary by procedure and payer.

Common Orthopedic Coding Errors That Trigger Claim Denials

Orthopedic claim denials often result from incorrect CPT codes, missing documentation, improper modifier use, and failure to meet payer requirements. These errors can delay reimbursement and increase administrative work for orthopedic practices.

Some of the common orthopedic coding errors that you should avoid to prevent claim denials;

Incorrect or outdated CPT code selection.
Forgetting to add laterality (the body side where the procedure is performed).
Incorrect or wrong modifier is used. Incomplete medical documentation that doesn’t support the diagnosis, procedure, and treatment plans.
Bundled services billed separately.
Missing prior authorization for high-cost treatments.
Mismatched CPT and ICD-10 codes.

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Conclusion

In short, orthopedic CPT codes are necessary for claim submission because they indicate which service or treatment was delivered to the patient. Without using these codes, you can’t bill for the service. From arthroscopy and joint replacement to E/M, spinal fusion, and fracture care, each treatment has its own CPT codes. A minor coding mistake can lead to denials or rejections. So, always use the most appropriate CPT codes, along with correct ICD-10 diagnosis codes and modifiers, for faster, more accurate reimbursement.

Frequently Asked Questions

What are the most commonly used orthopedic CPT codes?

Common orthopedic CPT codes include 27447 for total knee replacement, 27130 for total hip replacement, 29881 for knee arthroscopy with meniscectomy, and 20610 for major joint aspiration or injection without ultrasound guidance.

What is the difference between CPT codes 27447 and 27446?

CPT 27447 describes total knee replacement, while CPT 27446 describes partial knee replacement, also known as unicompartmental knee arthroplasty. The correct code depends on the procedure performed.

Which CPT codes are used for orthopedic imaging and diagnostic tests?

Common orthopedic imaging codes include 73562 for a three-view knee X-ray, 73721 for a lower-extremity joint MRI without contrast, and 73700 for a lower-extremity CT scan without contrast.

What documentation is required for orthopedic CPT coding?

Orthopedic coding requires patient history, physical examination findings, diagnosis, imaging reports when applicable, operative reports, laterality, and documentation supporting medical necessity. Complete records help ensure accurate coding and reimbursement.

How can orthopedic practices reduce claim denials and coding errors?

Orthopedic practices can reduce denials by verifying CPT and ICD-10-CM codes, checking modifier requirements, maintaining complete documentation, confirming prior authorization when required, and reviewing payer policies before submitting claims.

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