Summary & Overview
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.
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. |