27130 Hip replacement Medicare reimbursement rates in Rhode Island

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.