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27130 CPT Code: Total Hip Arthroplasty Billing

Last Updated: November 29, 2025

CPT 27130 represents Arthroplasty, acetabular and proximal femoral prosthetic replacement (Total Hip Arthroplasty), with or without autograft or allograft.

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2026 Medicare National Fee (27130): Non-Facility (Office): $1304.14 · Facility (Hospital): $1304.14
✓ 2,916 Medicare-Approved ICD-10 Diagnoses on file for 27130:

Included Components

Medicare bundles almost all aspects of the hip replacement into the primary code. You cannot bill separately for the creation of the hip socket, the femoral preparation, the bone grafts used within the primary joint, or the standard surgical approach.

Medical Necessity & ICD-10

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Total hip replacements are usually indicated for severe, end-stage osteoarthritis (M16.1-) or avascular necrosis (M87.05-). Documentation must typically show failure of conservative therapy prior to surgical intervention.

NCCI Edits and Modifier 22

If the hip replacement is exceptionally difficult due to massive prior trauma or severe deformity, the surgeon may append Modifier 22. This requires an extensive operative report detailing the extra time and effort required.

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