Summary & Overview
CPT 27134: Revision Total Hip Arthroplasty, Femoral and Acetabular Components
CPT code 27134 denotes revision of total hip arthroplasty with removal of a previously implanted prosthesis and replacement of both the femoral and acetabular components. This surgical code captures a high-complexity orthopedic procedure that is a common reason for hospitalization and major surgical resource use. Nationally, revision hip arthroplasty has implications for surgical quality measurement, device management, and payer coverage policies due to its cost and potential for complications.
Key payers addressed in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication outlines how payers typically classify and reimburse revision hip procedures, and highlights common clinical and coding considerations that affect billing and utilization.
Readers will find a concise overview of clinical context for 27134, typical sites of service, and the procedural elements that define the code. The report summarizes available national benchmarks and payer coverage patterns, notes relevant policy considerations for prior authorization and inpatient versus outpatient settings, and describes common billing modifiers and documentation points to support appropriate coding. Data not available in the input is identified where specific payer rules, associated taxonomies, and diagnosis mappings are absent.
Billing Code Overview
CPT code 27134 describes a revision of total hip arthroplasty in which the surgeon removes a previously implanted hip prosthesis and replaces both the femoral and acetabular components. The procedure may include use of a graft but does not require one.
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Service type: Revision total hip arthroplasty involving removal and replacement of both femoral and acetabular components.
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Typical site of service: Hospital operating room or ambulatory surgical center, depending on clinical complexity and patient condition.
Clinical & Coding Specifications
Clinical Context
A 72-year-old patient with a previously implanted total hip arthroplasty presents with progressive hip pain, decreased mobility, and radiographic evidence of component loosening and polyethylene wear. Preoperative evaluation includes history and physical, hip radiographs, inflammatory markers to assess for infection, and joint aspiration if infection is suspected. The surgical workflow for 27134 (revision of total hip arthroplasty, both femoral and acetabular components) typically includes preoperative templating, removal of the existing femoral and acetabular prosthetic components, debridement of osteolytic or infected tissue as indicated, preparation of bone surfaces, trialing, and implantation of revision femoral and acetabular components. Intraoperative decisions may include use of bone grafts or augments, extended trochanteric osteotomy for component removal, and management of bone defects. Postoperative care involves pain control, thromboprophylaxis, early mobilization with physical therapy, wound monitoring, and follow-up radiographs to confirm component position and stability.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when work, time, or technical effort substantially exceeds typical requirements for 27134 due to complexity. |