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CPT 27130: Total Hip Arthroplasty, Both Femoral and Acetabular Components
CPT code 27130 represents a primary total hip arthroplasty in which both the femoral and acetabular components of the hip joint are replaced with a prosthesis, with or without autograft or allograft. This procedure is a common and resource-intensive orthopedic surgery with substantial implications for inpatient and outpatient surgical capacity, episode cost, and post-acute utilization across the U.S. health system.
Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, United Healthcare, and Medicare. Readers will find a concise overview of the procedure’s clinical context, typical sites of service, and common diagnostic indications. The publication provides benchmarking information and comparisons across major payers, highlights related CPT codes for conversion and revision scenarios, and outlines coding context relevant to claims adjudication and care setting decisions.
Intended for clinicians, coding professionals, and policy analysts, the content covers clinical description, common diagnoses linked to the procedure, related procedure codes for conversions and revisions, and payer coverage considerations. Data not available in the input is noted where applicable.
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Billing Code Overview
CPT code 27130 describes a total hip arthroplasty in which the surgeon surgically replaces the hip joint with a prosthesis, replacing both the femoral and acetabular components. The procedure may be performed with or without the use of an autograft or allograft.
Service type: Surgical — Total hip replacement
Typical site of service: Inpatient hospital or ambulatory surgical center (operating room)
National Reimbursement Benchmarks
National means for CPT 27130 show a notable split: Medicare’s mean of $1,178.40 sits well below BUCA’s mean commercial level of $6,614.90, indicating that commercial negotiated averages can be roughly five to six times higher than Medicare for this code. Blue Cross Blue Shield and UnitedHealth Group means ($10,100 and $2,420.60 respectively) also sit above Medicare, while Aetna and Cigna cluster closer but still exceed Medicare’s mean.
Dispersion measured by the interquartile range (P75 minus P25) varies substantially. Blue Cross Blue Shield has the widest IQR at $10,144.10 (P75 $14,433.40 minus P25 $4,290.30), followed by BUCA at $6,413.80 and UnitedHealth Group at $1,432.80. Aetna and Cigna exhibit the tightest spreads, with IQRs of $1,445.00 and $1,446.80 respectively, signaling more concentrated commercial negotiated rates for those payers.