27156 Hip reconstruction Medicare reimbursement rates in California

This major reconstructive operation combines realignment of a pelvic bone around the hip with open repositioning of the hip and a femoral osteotomy. It is typically performed by an orthopedic surgeon, often a pediatric hip specialist, for a hip that remains dislocated or poorly aligned, such as in developmental dysplasia. The operation addresses the pelvic socket and femur together rather than treating only one bone or performing open reduction alone.

Report the code when the documented operation includes the combined pelvic osteotomy, open hip reduction, and femoral osteotomy. The operative report should identify the bones and components treated, the hip’s dislocated or dysplastic condition, and the reconstructive steps performed. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery services may be paid; co-surgeons require supporting documentation, and team surgery is not permitted.