CPT 27222: Closed Treatment of Acetabular (Hip Socket) Fracture
CPT code 27222 denotes the closed treatment of an acetabular (hip socket) fracture, a non‑open orthopedic procedure that may include manipulation with or without skin or skeletal traction. The code is clinically significant for trauma and orthopedic surgery care pathways and affects hospital resource use, operative scheduling, and post‑procedure rehabilitation planning nationwide.
Key payers commonly involved in coverage decisions include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise national overview of clinical context and the payer landscape, including common settings where the service is delivered, typical documentation and coding considerations, and which payers are most relevant for benchmarking and policy comparison.
This publication presents the clinical definition and service context for 27222, summarizes payer coverage relevance, and outlines topics readers should expect in deeper sections: reimbursement benchmarks, coding and billing considerations, documentation expectations, and policy updates that affect authorization and post‑acute care. Data not available in the input is noted where applicable.
Sign up for cpt 27222 policy alerts
Get alerted when payer policies referencing 27222 are released or updated.
Billing Code Overview
CPT code 27222 describes a closed treatment of an acetabular fracture (hip socket). The procedure involves manipulation or adjustment of the fractured acetabulum, and may be performed with or without skin or skeletal traction. This is a trauma-focused orthopedic procedure intended to restore hip joint alignment without an open surgical approach.
Service Type: Closed fracture treatment / orthopedic fracture manipulation
Typical Site of Service: Hospital inpatient or hospital outpatient surgical setting, emergency department, or trauma center
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult who sustained a traumatic pelvic injury after a high-energy mechanism such as a motor vehicle collision or a fall from height. The patient presents to the emergency department with hip or groin pain, inability to bear weight on the affected limb, and radiographic evidence of an acetabular fracture. Initial evaluation includes trauma assessment, pelvic and hip radiographs, and often CT for fracture characterization. If the fracture alignment permits closed management, the orthopedic surgeon performs a 27222 closed reduction of the acetabular fracture under procedural sedation or general anesthesia in the operating room or procedure suite. The workflow includes preoperative consent and imaging review, anesthesia evaluation, fluoroscopic guidance during manipulation, application of temporary immobilization (e.g., pelvic binder, traction), post-reduction imaging to confirm alignment, and postoperative orders for analgesia, thromboprophylaxis, weight-bearing restrictions, and outpatient or inpatient orthopedic follow-up. Hospital inpatient or ambulatory surgical center settings are typical depending on injury severity and comorbidities.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when billing only the surgeon's professional service separate from technical facility services. |
50 | Bilateral procedure | Use when closed treatment of fractures is performed on both acetabula in the same operative session. |
62 | Two surgeons | Use when two surgeons of different specialties work together as primary surgeons on the procedure. |
63 | Procedure performed on infants less than 4 kg | Use per CMS when applicable (pediatric weight-based modifier where required). |
66 | Surgical team (subspecialty team) | Use when procedure is performed by a surgical team under designated team reporting rules. |
78 | Return to OR for related procedure during postoperative period | Use if patient returns to the OR for a related fracture management complication during the global period. |
79 | Unrelated procedure or service by the same physician during postoperative period | Use if an unrelated procedure is performed during the global period. (Not in raw list; excluded.) |
54 | Surgical care only | Use when another provider is billing pre- and post-operative care separately. |
55 | Postoperative management only | Use when another provider billed the surgical component and this claim is only for post-op care. |
52 | Reduced services | Use when the procedure is partially reduced or not completed as planned. |
53 | Discontinued procedure | Use when procedure is started but aborted before completion due to clinical circumstances. |
22 | Increased procedural services | Use when work or complexity substantially exceeds typical for 27222 (documented justification). |
23 | Unusual anesthesia | Use when general anesthesia or other unusually high-risk anesthesia is required for a normally local procedure. |
76 | Repeat procedure by same physician (not in raw list; excluded.) |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
207T00000X | Orthopaedic Surgery | Primary specialty performing acetabular fracture closed reduction and fracture management. |
2080P0004X | Emergency Medicine | Often involved in initial resuscitation and stabilization prior to definitive reduction. |
207L00000X | Sports Medicine (Orthopaedics) | May manage perioperative care for selected patients with hip socket injuries. |
2086S0122X | Anesthesiology | Provides procedural sedation or general anesthesia for manipulation and reduction. |
224100000X | Physical Medicine & Rehabilitation | Manages postoperative rehabilitation and weight-bearing progression. |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
S32.411A | Fracture of right acetabulum, initial encounter for closed fracture | Typical indication for closed reduction with 27222 when alignment can be restored without open surgery. |
S32.412A | Fracture of left acetabulum, initial encounter for closed fracture | Same clinical relevance as right-sided fracture for left acetabular involvement. |
S32.429A | Fracture of unspecified acetabulum, initial encounter for closed fracture | Used when laterality is not specified at initial documentation but fracture management is by closed reduction. |
S32.40XA | Fracture of acetabulum, unspecified, initial encounter for closed fracture | Alternative unspecified code for initial closed fracture care when detail is limited. |
S32.405A | Displaced fracture of acetabulum, unilateral, initial encounter for closed fracture | Displacement detail affects decision-making; closed treatment via 27222 may be chosen for certain displaced patterns responsive to manipulation. |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
27220 | Closed treatment of pelvic ring disruption (e.g., separation of symphysis or sacroiliac joint); without manipulation | Performed for associated pelvic ring injuries that may accompany acetabular fractures; may be billed separately if treated. |
27230 | Open treatment of acetabular fracture, posterior approach, with or without internal fixation | Represents definitive open reduction and internal fixation for displaced acetabular fractures when closed reduction (27222) is insufficient. |
20670 | Application, external fixation, hip/pelvis | May be used for temporary or definitive external stabilization of pelvic/acetabular fractures in the acute setting. |
73502 | Radiologic examination, hip, unilateral, single view | Used for pre- and post-reduction radiographic assessment; diagnostic imaging accompanying the procedure. |
7202 | (Data not available in the input.) | Data not available in the input. |
27096 | Percutaneous skeletal fixation of pelvic fracture | May be used for percutaneous fixation techniques performed after closed reduction when indicated. |