Billing code 27130: Hip replacementMedicare rate & RVUs in Illinois
Report this procedure when a surgeon replaces both the femoral and acetabular sides of a hip joint with prosthetic components.
CMS doesn’t publish an office rate for 27130 in Illinois.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 27130 covers
An orthopedic surgeon performs a total hip arthroplasty by replacing the damaged femoral head and the hip socket with prosthetic components. It is commonly performed for advanced hip arthritis or other conditions that have severely damaged the joint. The procedure is typically done in a hospital or other surgical setting; the operative report should establish that both sides of the joint were replaced, rather than only the femoral head or a component of an existing implant.
Select this code for a primary total replacement, not a partial replacement, conversion after prior hip surgery, or revision of an existing prosthesis. Document the operative work, the components implanted, the side treated, and whether the procedure was primary or a conversion or revision. CMS assigns a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included. If multiple procedures are performed in the same session, the highest-valued procedure is paid in full and others at 50%. For bilateral procedures reported with modifier 50, CMS pays at 150%. An assistant at surgery may be paid; co-surgeons are paid only with supporting documentation, and team surgery is not permitted.
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
Where 27130 pays more and less in Illinois
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Chicago | Unavailable | $1,343.61 |
| East St. Louis | Unavailable | $1,268.11 |
| Rest Of Illinois | Unavailable | $1,204.38 |
| Suburban Chicago | Unavailable | $1,281.40 |
How the 27130 rate is calculated
Each of 27130’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 27130
RVUs × geographic indexes × conversion factor
Work19.11
19.11 RVUs× 1.000 GPCI
Practice expense11.63
11.63 RVUs× 1.000 GPCI
Malpractice4.05
4.05 RVUs× 1.000 GPCI
Adjusted RVUs
34.7900
Conversion factor
$33.4009
Medicare rate
$1,162.02
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 27130
27130 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 27130
Hip replacement
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.69/0.21 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 27130
Hip replacement
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
27130 without 50 · national facility
$1,162.02
Hip replacement
27130-50 · Bilateral: 150%
$1,743.03
Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).
27130 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 27125Hip replacement
- 27125 is for partial hip replacement, rather than replacement of both the femoral and acetabular sides.
- 27132Hip replacement
- 27132 describes conversion to total hip arthroplasty after prior hip surgery; 27130 is for a primary total replacement.
- 27134Hip revision
- 27134 is for revision of an existing total hip replacement involving both components. 27130 describes a primary replacement.
- 27137Hip revision
- 27137 is for revision of the acetabular component only. Use 27130 for primary replacement of both sides of the joint.
27130 billing questions
When should I report this instead of a partial hip replacement?
Report this code when both the femoral and acetabular sides are replaced. A partial replacement, such as a femoral head replacement without replacement of the socket, is reported with 27125.
How is a conversion after prior hip surgery distinguished?
Use 27132 when prior hip surgery is converted to a total hip arthroplasty. The operative documentation should clarify whether the surgeon is performing a primary replacement, a conversion, or revision of an existing prosthesis.
Are related postoperative visits included?
Yes. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How is a bilateral procedure reported?
For bilateral total hip replacements performed in the same session, report modifier 50. CMS pays the bilateral procedure at 150%.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeons are paid only when supporting documentation is provided; team surgery is not permitted.
What happens when another procedure is performed in the same session?
Under the standard multiple procedure reduction, CMS pays the highest-valued procedure in full and other procedures at 50%. The operative record should support each procedure reported.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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