Summary & Overview
CPT 27035: Hip Joint Nerve Denervation for Arthritis Pain
CPT code 27035 identifies a surgical denervation procedure that severs or ablates intra–articular branches of the sciatic, femoral, or obturator nerves to reduce hip pain from arthritis. Nationally, this code is relevant for specialty surgical practices and payers managing musculoskeletal and chronic pain care, as it represents an interventional alternative when conservative therapies are insufficient.
Payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find clinical context on the procedure’s intent and typical settings, a synopsis of coverage patterns among major national payers, and benchmarks used to evaluate utilization and authorization practices. The publication also summarizes common billing modifiers associated with surgical services and notes where data was not provided.
This summary provides a concise reference for clinicians, coding professionals, and policy analysts seeking to understand where 27035 fits within surgical pain-management options, payer coverage considerations, and facility-based delivery. It is written for a national audience and focuses on the code’s clinical meaning, typical service locations, and payer relevance without jurisdiction-specific guidance.
Billing Code Overview
CPT code 27035 describes a neuroablative procedure targeting the intra-articular nerve supply to the hip joint. The provider intentionally cuts or destroys intrapelvic or extrapelvic branches of the sciatic, femoral, or obturator nerves to reduce hip pain caused by arthritis.
Service type: Surgical neurotomy/denervation for pain relief
Typical site of service: Hospital outpatient department or ambulatory surgical center, depending on clinical setting and anesthesia requirements.
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A 68-year-old patient with long-standing osteoarthritis of the hip presents with chronic, focal hip joint pain refractory to optimized medical management including NSAIDs, physical therapy, intra-articular steroid injections, and activity modification. Imaging (radiographs and MRI) shows degenerative changes without a surgical fracture or indication for total hip arthroplasty due to comorbidities or patient preference. After diagnostic nerve block of the intra-articular branches of the femoral and obturator nerves provides temporary pain relief, the patient is scheduled for neurotomy of the intra-articular branches of the sciatic, femoral, or obturator nerves to reduce hip pain.
The clinical workflow includes pre-procedure evaluation (history, medication review, informed consent), image-guided diagnostic nerve block, peri-procedural anesthesia (local with or without sedation), placement in a procedure suite or ambulatory surgical center, neurotomy (cutting or thermal ablation) of targeted intra-articular nerve branches, immediate post-procedure monitoring for hemostasis and neurovascular status, and short-term follow-up to assess pain relief and function. Typical site of service is an ambulatory surgical center or hospital outpatient department. The service type is a neurolytic/denervation procedure of intra-articular hip joint nerve branches.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier / Normal reporting | Use when submitting the primary procedure without additional modifier requirement. |