CPT 27253: Open Treatment of Hip Joint Dislocation, No Internal Fixation - OpenPayer

Summary & Overview

CPT 27253: Open Treatment of Hip Joint Dislocation, No Internal Fixation

CPT code 27253 denotes an open surgical procedure to treat a hip joint dislocation without placement of internal fixation devices. This code captures care for traumatic or injury-related hip dislocations requiring surgical exposure and reduction or repair, and is relevant to orthopedic trauma, emergency surgery, and post-injury rehabilitation pathways. Nationally, accurate coding for open hip dislocation treatment matters for resource allocation, quality measurement, and payment integrity across inpatient and ambulatory surgical settings.

Key payers addressed in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical context for CPT code 27253, expected sites of service, and the types of services it represents. The publication outlines common billing considerations and typical modifier usage while noting where input data are not available. It also provides benchmarks and policy context useful for provider billing teams, compliance staff, and payers evaluating claims for open surgical management of hip dislocation.

The report is intended for a national audience and covers clinical definitions, payment and coding implications, and operational considerations relevant to hospitals, ambulatory surgical centers, and payers.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare27253CPThip dislocationorthopedic surgerysurgical treatmenttraumaoperating roominpatientambulatory surgical center

Billing Code Overview

CPT code 27253 describes an open treatment of a hip joint dislocation without the use of internal fixation implants such as pins, wires, or screws. The procedure addresses an abnormal separation of the hip joint typically caused by trauma or injury and involves surgical manipulation to restore joint alignment.

Service type: Open surgical treatment of hip dislocation

Typical site of service: Operating room or surgical suite in an acute care hospital or ambulatory surgical center

Clinical & Coding Specifications

Clinical Context

A 62-year-old male presents to the emergency department after a fall from standing with acute left hip pain, inability to bear weight, and a visibly shortened, externally rotated lower extremity. Initial evaluation includes trauma assessment, focused musculoskeletal exam, radiographs of the pelvis and left hip that confirm a posterior hip dislocation without associated femoral neck fracture. Closed reduction attempts under procedural sedation are unsuccessful due to soft-tissue interposition and persistent instability. The orthopedic surgeon proceeds to the operating room for open treatment of the hip dislocation. Under general anesthesia, a standard posterior approach to the hip is performed, the femoral head is cleared of interposed capsular tissue and contused labrum, joint congruity is restored manually, and the hip is evaluated for stability through a range of motion. No internal fixation (pins, wires, screws) is placed. Postoperative workflow includes recovery room monitoring, serial neurovascular checks, postoperative radiographs to confirm reduction, DVT prophylaxis planning, pain control, and discharge planning with restricted weight-bearing and orthopedic follow-up within 1–2 weeks.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	Use when work required for the open reduction is substantially greater than typical (extensive dissection, prolonged operative time) and supporting documentation is present.

CPT 27265: Closed Reduction of Dislocated Prosthetic Hip Without Anesthesia

cpt-27246-closed-treatment-greater-trochanteric-fracture

CPT 27246: Closed Treatment of Greater Trochanteric Femur Fracture

cpt-27266-closed-reduction-prosthetic-hip-dislocation

CPT 27266: Closed Reduction of Dislocated Prosthetic Hip

cpt-27232-closed-treatment-femoral-neck-fracture

CPT 27232: Closed Treatment of Femoral Neck Fracture

cpt-27220-closed-treatment-acetabular-fracture

CPT 27220: Closed Treatment of Acetabular (Hip Socket) Fracture

cpt-27250-closed-treatment-traumatic-hip-dislocation-no-general-anesthesia

CPT 27250: Closed Treatment of Traumatic Hip Joint Dislocation, Without General Anesthesia

cpt-27226-acetabular-wall-fracture-open-fixation

CPT 27226: Open Fixation of Acetabular Wall Fracture

cpt-27257-closed-treatment-developmental-hip-dislocation

CPT 27257: Closed Treatment of Developmental Hip Dislocation

cpt-27197-posterior-pelvic-fracture-treatment-no-manipulation

CPT 27197: Treatment of Posterior Pelvic Fracture/Separation Without Manipulation

cpt-27245-femoral-fracture-intramedullary-fixation-open-treatment

CPT 27245: Open Femoral Fracture Fixation with Intramedullary Implant

Showing 1–10 of 35

Taxonomy Code	Specialty	Notes
Data not available in the input.	Data not available in the input.	Data not available in the input.
`2080S0102X`	Orthopaedic Surgery	Adult orthopaedic surgeons commonly perform open hip reductions.
`207L00000X`	Emergency Medicine	Emergency physicians often provide initial assessment and closed reduction attempts.
`2082P0800X`	Pediatric Orthopaedic Surgery	Pediatric orthopaedists manage hip dislocations in children when applicable.
`208100000X`	General Surgery	Trauma/general surgeons may be involved in multi-system trauma requiring open reduction as part of care.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`S73.001A`	Unspecified dislocation of right hip, initial encounter	Represents an acute hip dislocation on the right side requiring reduction; used for initial ED/surgical encounter.
`S73.002A`	Unspecified dislocation of left hip, initial encounter	Represents an acute hip dislocation on the left side requiring reduction; used for initial ED/surgical encounter.
`S73.101A`	Posterior dislocation of right hip, initial encounter	Posterior dislocations are the most common pattern after posterior-directed trauma; clinically indicated for open reduction if closed reduction fails.
`S73.102A`	Posterior dislocation of left hip, initial encounter	As above for the left hip.
`S73.111A`	Anterior dislocation of right hip, initial encounter	Anterior dislocations are less common but relevant when present and may require open treatment.
`S73.112A`	Anterior dislocation of left hip, initial encounter	As above for the left hip.
`S72.001A`	Fracture of unspecified part of neck of femur, right, initial encounter for closed fracture	Included when a femoral neck fracture is present concurrently; may change coding and operative approach.
`S72.002A`	Fracture of unspecified part of neck of femur, left, initial encounter for closed fracture	As above for left-sided femoral neck fracture.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`27250`	Closed treatment of hip dislocation; without anesthesia or with local anesthesia only	Performed prior to open treatment when closed reduction is attempted in the ED or operating room.
`27252`	Open treatment of hip dislocation with internal fixation, with or without bone graft	Used when open reduction requires internal fixation (pins, wires, screws); contrasts with `27253` which specifies no internal fixation.
`27095`	Arthrotomy, hip, for drainage; without removal of prosthesis	May be performed if septic arthritis is suspected alongside dislocation management.
`73502`	Radiologic exam, hip, unilateral, AP and lateral	Performed pre- and postoperatively to document dislocation and reduction.
`99144`	Moderate sedation services provided by the same physician performing a procedure (when applicable)	May apply when procedural sedation is used for closed attempts prior to open reduction; facility and payer rules vary.

OpenPayer