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CPT 27132: Revision Total Hip Arthroplasty, Both Components Replaced
CPT code 27132 denotes a revision total hip arthroplasty in which both the femoral and acetabular components are removed and replaced, with or without autograft or allograft. This procedure is clinically significant nationwide because it addresses prosthetic failure, infection, instability, or periprosthetic bone loss and often requires complex reconstruction. Payers frequently apply specific medical necessity criteria and coverage rules to revision arthroplasty due to its clinical complexity and cost implications. Key payers in most analyses include Aetna, Blue Cross Blue Shield, Cigna Health, United Healthcare, and Medicare.
Readers will find a concise overview of the clinical context for 27132, typical sites of service, and how this code relates to related procedural codes such as removal of hip prosthesis and intertrochanteric osteotomy. The publication summarizes common billing considerations, typical clinical indications, and the role of 27132 in care pathways for patients with failing hip prostheses or complex hip pathology. The piece also highlights common documentation elements and contract-level coverage variability to watch for when billing this high-acuity orthopedic procedure.
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Billing Code Overview
CPT code 27132 describes a surgical procedure to revise a previously operated hip joint by replacing both the femoral and acetabular components with a prosthesis, with or without use of autograft or allograft. This is a revision hip arthroplasty performed when a prior hip surgery (other than a primary total hip arthroplasty) requires replacement of both components of the artificial hip joint.
Service Type: Revision total hip arthroplasty, both components replaced
Typical Site of Service: Inpatient hospital or ambulatory surgical center, depending on clinical complexity and payer rules
National Reimbursement Benchmarks
Nationally, Medicare’s mean rate of $1,524.50 sits below BUCA’s average commercial mean of $7,067.00, indicating substantial upward pressure in commercial negotiated levels versus the Medicare baseline. The gap between Medicare and BUCA is $5,542.50, reflecting that commercial contractual norms for this CPT code are several times higher than the federal program average across localities. This contrast highlights payer-type differences rather than local variation within Medicare, which has a clustered interquartile span around its $1,504 median locality value.
Dispersion (P75–P25) varies meaningfully across payers: Blue Cross Blue Shield shows the widest IQR at $11,584.90 ($15,284.90 − $3,701.50), followed by BUCA with $7,351.80 ($10,014.60 − $2,663.20). UnitedHealth Group’s IQR is $1,806.40, Aetna’s is $1,441.10, and Cigna’s is $1,873.60, making Aetna the tightest among those with reported quartiles while Blue Cross Blue Shield is the most dispersed.