Summary & Overview
CPT 27122: Acetabuloplasty with Femoral Head Resection
CPT code 27122 represents a major orthopedic surgical procedure in which the surgeon performs an acetabuloplasty and resects the femoral head to address severe hip infection or irreparable joint damage. Nationally, this code captures care for patients requiring salvage or infection-directed hip surgery when reconstruction is not feasible; it is clinically significant because these cases are high-acuity, resource-intensive, and may involve complex perioperative management.
Key payers included in the analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical context for the procedure, payer coverage considerations, common modifiers associated with surgical billing, and an overview of related service-line implications. The publication summarizes typical sites of service and service type, and describes what benchmarks and policy topics are relevant for organizations managing these cases.
This summary provides clinicians, billing professionals, and policy analysts with a national view of CPT code 27122, clarifying its clinical intent and administrative relevance. Data not available in the input are identified where applicable in the full publication.
Billing Code Overview
CPT code 27122 describes a surgical procedure that combines acetabuloplasty (reshaping the acetabulum, the socket of the hip joint) with resection of the femoral head. The procedure is performed to relieve pain and remove infected or nonviable bone when the hip cannot be reconstructed, commonly in the setting of severe hip infection or irreparable joint damage.
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Service type: Surgical orthopedic procedure involving removal and reshaping of hip joint structures
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Typical site of service: Inpatient or outpatient hospital operating room, depending on patient acuity and infection status
Clinical & Coding Specifications
Clinical Context
A 68-year-old male with a long-standing history of severe osteomyelitis of the hip and a chronically infected, nonfunctional hip joint presents with uncontrolled pain, drainage, and systemic inflammatory markers despite prolonged antibiotics. The orthopedic surgeon determines that joint-preserving reconstruction is not feasible because of extensive acetabular bone loss and a grossly destroyed femoral head. The patient is scheduled for an acetabuloplasty with femoral head resection to remove infected and nonviable bone, relieve pain, and control local sepsis.
Preoperative workflow includes history and physical, laboratory evaluation (CBC, inflammatory markers), targeted imaging (plain radiographs and CT of the pelvis to assess bone loss), and perioperative antibiotics per infectious disease guidance. The procedure is performed in an operating room with general or regional anesthesia. Intraoperative steps include surgical approach to the hip (commonly posterior or lateral), debridement of infected soft tissue, acetabuloplasty to reshape and resect diseased acetabular bone as indicated, resection (excision) of the femoral head, thorough irrigation, and placement of drains or local antibiotic carriers when indicated. Postoperative care involves inpatient monitoring for infection control, pain management, wound care, and coordination with physical therapy for limited weight-bearing or assistive device use. Subsequent plans may include staged reimplantation or definitive arthrodesis or prosthetic reconstruction only if infection is eradicated and bone stock permits.
Coding Specifications
| Modifier | Description | When to Use |
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