Summary & Overview
CPT 27250: Closed Treatment of Traumatic Hip Joint Dislocation, Without General Anesthesia
CPT code 27250 represents the closed treatment (reduction) of a traumatic hip joint dislocation performed without general anesthesia. This procedure is a nationally relevant acute orthopedic intervention commonly performed in emergency departments and procedural areas to restore hip alignment after traumatic displacement. Accurate coding of this service supports appropriate claims processing, quality tracking, and timely patient care coordination.
Key payers typically covering this service in national analyses include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of clinical context and typical settings for the procedure, a synthesis of payer coverage considerations, and benchmarking content where available. The publication also outlines coding relationships and common modifiers used with the service line.
This summary is intended for clinicians, billing professionals, and policy analysts seeking concise guidance on the clinical nature of CPT code 27250, its role in acute orthopedic care, and the payer landscape that commonly reimburses the service. Data not available in the input is noted where relevant in detailed sections.
Billing Code Overview
CPT code 27250 describes the closed treatment of a traumatic hip joint dislocation performed without general anesthesia. The procedure involves manual or closed reduction techniques to restore normal joint alignment after a traumatic dislocation of the hip.
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Service type: Closed reduction of traumatic hip dislocation
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Typical site of service: Emergency department or procedural treatment area (ambulatory surgery center or hospital procedure room) where conscious sedation or local/regional anesthesia can be provided
Clinical & Coding Specifications
Clinical Context
A 42-year-old male motor vehicle collision patient presents to the emergency department with an acutely painful, externally rotated left lower extremity and inability to ambulate. Imaging confirms a posterior dislocation of the left hip without associated open wound. The orthopaedic trauma surgeon evaluates the patient, documents neurovascular status, and elects to perform a 27250 closed reduction of the traumatic hip joint dislocation in the ED procedural suite under conscious sedation (no general anesthesia).
The clinical workflow: initial primary survey and immobilization, urgent AP pelvis and hip radiographs (and CT if concern for fracture), informed consent for closed reduction, procedural sedation by emergency or anesthesia provider as appropriate, closed reduction maneuvers performed by the orthopaedic surgeon, post-reduction radiographs to confirm joint concentricity, neurovascular recheck, documentation of pre- and post-procedure status, and disposition with weight-bearing and follow-up instructions.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
23 | Unusual anesthesia | Use when procedure requires general anesthesia but is performed under unusual circumstances; rarely applied here but included for completeness when anesthesia status is atypical |
52 | Reduced services | Use when a closed reduction is attempted but is incomplete or substantially reduced in scope compared to the full service |
53 | Discontinued procedure | Use when the attempt at closed reduction is started but halted due to patient instability or unexpected complication |
59 | Distinct procedural service | Use to indicate a separate and distinct procedure when other unrelated procedures are billed on same date (e.g., separate wound irrigation unrelated to reduction) |
62 | Two surgeons | Use when two surgeons from different specialties perform distinct portions of the closed reduction and both bill |
66 | Surgical team | Use when a surgical team approach is documented for complex management of the dislocation |
73 | Discontinued outpatient hospital/ambulatory surgery before anesthesia | Use if the procedure is planned in an outpatient/same-day setting but is cancelled after preparation without anesthesia being administered |
76 | Repeat procedure by same physician | Use when a closed reduction is repeated by the same physician during the same encounter due to re-dislocation |
77 | Repeat procedure by another physician | Use when a second physician repeats the closed reduction during the same encounter |
RT | Right side | Use to designate the right hip when billing laterality-specific reporting is required |
LT | Left side | Use to designate the left hip when billing laterality-specific reporting is required |
22 | Increased procedural services | Use when the closed reduction requires substantially greater effort, time, or complexity than typical (document rationale) |
23 | Unusual anesthesia | Use when the procedure is performed under anesthesia circumstances that are atypical for this service (duplicate of above; clarify if institutional policy requires) |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
207X00000X | Orthopaedic Surgery | Orthopaedic traumatologists commonly perform hip closed reductions in ED or OR settings |
207L00000X | Sports Medicine (Orthopaedic) | Sports/orthopaedic surgeons may manage hip dislocations from athletic injuries |
2080P0006X | Emergency Medicine | Emergency physicians frequently perform closed reductions under sedation in the ED |
163W00000X | Anesthesiology | Anesthesia providers may administer sedation or anesthesia for reduction maneuvers |
310400000X | Critical Care Medicine | Critical care specialists may be involved when the patient is hemodynamically unstable |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
S73.001A | Unspecified dislocation of right hip, initial encounter | Posterior/anterior hip dislocation diagnosis that directly justifies 27250 when on the right side |
S73.002A | Unspecified dislocation of left hip, initial encounter | Posterior/anterior hip dislocation diagnosis that directly justifies 27250 when on the left side |
S73.011A | Posterior dislocation of right hip, initial encounter | Posterior hip dislocations are the most common traumatic hip dislocations and are a primary indication for closed reduction |
S73.012A | Posterior dislocation of left hip, initial encounter | As above for the left hip; guides laterality reporting with RT/LT modifiers |
S72.001A | Fracture of unspecified part of right femur, initial encounter | Included when femoral fractures accompany the dislocation; may change management to open reduction/fixation |
S72.002A | Fracture of unspecified part of left femur, initial encounter | As above for left-sided femoral fractures |
S33.4XXA | Sprain of ligaments of pelvis, initial encounter | Soft tissue injuries around the hip/pelvis that can coexist and affect post-reduction care |
M25.659 | Pain in unspecified hip | Symptom code sometimes used for follow-up visits documenting persistent hip pain after reduction |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
73502 | Radiologic examination, hip, two views, unilateral | Pre- and post-reduction radiographs to confirm dislocation and successful reduction |
73510 | Radiologic examination, pelvis, 1 or 2 views | Initial AP pelvis radiograph often obtained to evaluate hip alignment and associated injuries |
99144 | Moderate sedation services provided by the same physician performing the procedure | Billed when the physician provides conscious sedation for the closed reduction (check payer rules for bundling) |
20610 | Arthrocentesis, aspiration and/or injection; major joint or bursa (e.g., hip) | May be performed if joint aspiration is needed to relieve hemarthrosis or obtain diagnostic fluid before reduction in select cases |
27447 | Open treatment of femoral fracture, with or without internal fixation | Related if the dislocation is associated with a femoral fracture requiring open surgical fixation after closed reduction attempts |
27220 | Closed treatment of pelvic ring disruption | Performed when pelvic or acetabular injuries accompany the hip dislocation and require closed stabilization |