CPT 27125 Femoral Head Replacement Reimbursement | OpenPayer

Summary & Overview

CPT 27125: Femoral Head Replacement (Hemiarthroplasty) for Stabilization

CPT code 27125 represents femoral head removal with prosthetic replacement while leaving the acetabulum intact — commonly referred to as a femoral head replacement or hemiarthroplasty for stabilization. This procedure is a key surgical option for patients with displaced femoral neck fractures, avascular necrosis of the femoral head, or severe focal femoral head damage where acetabular replacement is not indicated. Nationally, 27125 is central to orthopedic trauma and elderly fracture care pathways because it often determines length of stay, implant costs, and post-acute rehabilitation needs.

Key payers included in the analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a clinical and billing-focused overview of the procedure, reimbursement benchmarks where available, common billing modifiers used with the code, and the clinical context that informs appropriate use. The publication highlights service-line implications for inpatient surgical departments and short-stay centers, and summarizes typical sites of service and care goals tied to 27125.

Data not available in the input for associated taxonomies, specific ICD-10 diagnoses, and comparative utilization metrics.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareCPT 27125hemiarthroplastyhip surgeryorthopedicssurgical proceduresfemoral head replacementinpatient surgery

Billing Code Overview

CPT code 27125 describes a surgical procedure in which the damaged head of the femur is removed and replaced with a prosthetic device while the acetabulum is not replaced. The primary goal of the procedure is to achieve stabilization of the hip joint.

Service type: Orthopedic surgical procedure — femoral head replacement (hemiarthroplasty) for stabilization
Typical site of service: Inpatient hospital or short-stay surgical center, as part of operative management for hip fractures or severe femoral head damage

Data not available in the input.

Clinical & Coding Specifications

Clinical Context

A 72-year-old female presents with progressive right hip pain, limited weight-bearing ability, and decreased range of motion after a displaced femoral neck fracture sustained in a ground-level fall. Initial evaluation in the emergency department includes radiographs confirming a displaced intracapsular femoral neck fracture with avascular changes to the femoral head. Medical optimization occurs on the inpatient orthopedic service, including assessment of cardiopulmonary status, anticoagulation management, and preoperative anesthesia evaluation. The patient is taken to the operating room for a femoral head resection and implantation of a unipolar or bipolar prosthetic femoral head without acetabular replacement to achieve pain relief and hip stability. Typical intraoperative steps include removal of the native femoral head, canal preparation, trialing, definitive prosthesis implantation, and wound closure. Postoperative care includes pain control, venous thromboembolism prophylaxis, physical therapy for gait training with partial to full weight-bearing as tolerated, and follow-up radiographs to assess prosthesis position and stability. Typical site of service is an inpatient hospital operating room; ambulatory surgical centers may be used for elective cases in healthier patients. Service type: surgical, orthopedic — partial hip arthroplasty (femoral head replacement only) aimed at stabilization.

Coding Specifications

Modifier	Description	When to Use
`00`	No modifier (default)	Used when no specific modifier applies to the service.

CPT 27185: Trochanteric Epiphysiodesis for Proximal Femoral Growth Modulation

27132-CONVERSION-OF-PREVIOUS-HIP-SURGERY-TO-TOTAL-HIP

CPT 27132: Conversion to Total Hip Arthroplasty

CPT-27156-PELVIC-AND-FEMORAL-OSTEOTOMY-HIP-REDUCTION

CPT 27156: Pelvic and Femoral Osteotomy with Hip Reduction

CPT-27110-ILIOPSOAS-TRANSFER-GREATER-TROCHANTER

CPT 27110: Iliopsoas Transfer to Greater Trochanter

CPT-27137-HIP-ACETABULAR-COMPONENT-REVISION

CPT 27137: Revision Hip Arthroplasty, Acetabular Component

CPT-27179-FEMORAL-NECK-OSTEOTOMY-SLIPPED-EPIPHYSIS

CPT 27179: Femoral Neck Osteotomy for Slipped Femoral Epiphysis

CPT-27111-ILIOPSOAS-TRANSFER-FEMORAL-NECK-HIP-STABILITY

CPT 27111: Iliopsoas Transfer to Femoral Neck for Hip Stability

CPT-27181-INTERTROCHANTERIC-OSTEOTOMY-SLAP-FEMORAL-EPIPHYSIS-INTERNAL-FIXATION

CPT 27181: Intertrochanteric Osteotomy for Slipped Femoral Epiphysis with Fixation

CPT-27100-EXTERNAL-OBLIQUE-TRANSFER-HIP-ABDUCTOR-RECONSTRUCTION

CPT 27100: External Oblique Transfer to Greater Trochanter

CPT-27170-PROXIMAL-FEMUR-BONE-GRAFTING

CPT 27170: Bone Graft for Proximal Femoral Defect

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Taxonomy Code	Specialty	Notes
Data not available in the input.	Orthopedic Surgery	Orthopedic surgeons most commonly perform `27125` for femoral head replacement.
Data not available in the input.	Trauma Surgery / Orthopedics	Orthopedic trauma specialists perform this procedure for acute fractures.
Data not available in the input.	Geriatric Orthopedics	Surgeons with geriatric focus often manage frail elderly patients with femoral neck fractures.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`S72.0`	Fracture of neck of femur	Common indication for femoral head replacement when fracture is displaced in elderly patients.
`M16.11`	Unilateral primary osteoarthritis, right hip	Advanced osteoarthritis with femoral head collapse can lead to femoral head replacement considerations in select patients.
`M84.451`	Pathological fracture, femur, right, initial encounter for fracture	Pathologic fractures of the femoral neck related to bone metastasis or osteoporosis may necessitate head replacement.
`S72.001`	Fracture of head of femur, unspecified femur, initial encounter	Direct traumatic injury to the femoral head that may require prosthetic replacement for stability.
`R68.2`	Fall, initial encounter	Falls are a typical mechanism resulting in femoral neck fractures leading to this procedure.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`27096`	Open treatment of posterior pelvic disruption (Note: placeholder if needed)	Data not available in the input.
`27236`	Closed treatment of femoral fracture; proximal end with manipulation	Performed when an initial attempt at closed reduction is undertaken instead of arthroplasty for certain femoral neck fractures.
`27130`	Total hip arthroplasty, both femoral and acetabular components	Alternative definitive procedure when both femoral head and acetabulum are replaced instead of femoral head only.
`27125`	Hemiarthroplasty, femoral head and partial neck prosthesis; includes prosthesis insertion	Primary procedure described — femoral head replacement without acetabular replacement to achieve stabilization.
`73630`	Radiologic exam, hip, unilateral, complete, minimum three projections	Commonly obtained intraoperatively or postoperatively to confirm prosthesis position and alignment.

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