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.
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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.
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Service type: Orthopedic surgical procedure — femoral head replacement (hemiarthroplasty) for stabilization
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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. |
11 | Office or other outpatient visit for the evaluation and management of an established patient (Note: here used as placeholder from list) | Applied when an unrelated E/M service is billed by the same provider on the same day as a procedure when payer policy allows. |
22 | Unusual procedural services | Use when the procedure requires substantially greater work than typical due to complexity or extended operating time. |
23 | Unusual anesthesia | Append when general anesthesia is medically contraindicated and local/regional anesthesia is used because of medical necessity. |
50 | Bilateral procedure | Use when a comparable procedure is performed on the contralateral hip during the same operative session. |
51 | Multiple procedures | Applied when multiple distinct procedures are performed during the same operative session in addition to the primary procedure. |
52 | Reduced services | Use when the service performed is partially reduced or not completed as originally planned. |
53 | Discontinued procedure | Applied when the surgical procedure is started but discontinued due to extenuating circumstances or patient safety concerns. |
62 | Two surgeons | Use when two surgeons work together as primary surgeons performing distinct portions of the procedure. |
66 | Surgical team | Applied when a surgical team with multiple surgeons provides the procedure and team billing is allowed. |
78 | Unplanned return to the operating room | Use when the patient returns to the OR for a related procedure during the postoperative global period. |
79 | (Not in provided list) | Data not available in the input. |
LT | Left side | Append when the procedure is performed on the left hip. |
RT | Right side | Append when the procedure is performed on the right hip. |
| 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. |