CPT 27254: Open Treatment of Traumatic Hip Dislocation with Fracture - OpenPayer

Summary & Overview

CPT 27254: Open Treatment of Traumatic Hip Dislocation with Fracture

CPT code 27254 denotes an open surgical procedure for treatment of a traumatic hip joint dislocation when combined with acetabular wall and femoral head fracture management. It covers operative repair of a complex hip injury that may involve reduction of the dislocation and direct treatment of associated fractures, with or without internal fixation devices. This code is clinically significant because traumatic hip dislocations with acetabular or femoral head fractures often require coordinated orthopedic trauma care, hospital-based operating room resources, and multidisciplinary perioperative management, influencing utilization and cost patterns nationally.

Key payers included in the analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context, common sites of service, and how payers typically categorize this surgical service. The publication outlines benchmarks and coverage patterns where available, summarizes relevant policy considerations affecting authorization and coding choices, and situates the code within typical orthopedic trauma care pathways. The piece also highlights areas where data is not present in the input, such as specific ICD-10 pairings, payer-specific reimbursement rates, and associated taxonomies.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareCPT 27254hip dislocationacetabular fracturefemoral head fractureorthopedic surgerytrauma surgeryoperative repairhospital inpatientsurgical coding

Billing Code Overview

CPT code 27254 describes an open treatment of a traumatic hip joint dislocation performed in the context of associated fractures of the acetabular wall and femoral head. The procedure addresses an abnormal separation of the hip joint typically caused by significant trauma and may include repair of associated bony injuries.

Service Type: Open surgical treatment for traumatic hip dislocation with acetabular and femoral head fracture management

Typical Site of Service: Inpatient or outpatient hospital surgical setting (operating room), often within orthopedic trauma or surgical departments

Clinical & Coding Specifications

Clinical Context

A 42-year-old male motor vehicle collision patient arrives to the emergency department with severe left hip pain, limb shortening, and inability to bear weight after a dashboard injury. Imaging (pelvic radiograph and CT) demonstrates a traumatic posterior hip dislocation with associated posterior acetabular wall fracture and a marginal femoral head impaction fragment. Closed reduction in the ED is attempted but is unsuccessful due to incarceration of fracture fragments and instability. The patient is taken urgently to the operating room for open reduction of the hip with treatment of the acetabular wall and femoral head fractures. Intraoperatively the surgeon performs open reduction of the dislocation, debridement of interposed fragments, and fixation of the acetabular wall and femoral head as indicated using screws and/or plates. Hemostasis is obtained, and the patient is transferred to post-anesthesia care for monitoring. Typical workflow includes preoperative consent, perioperative antibiotics, intraoperative fluoroscopy, implant selection and fixation, postoperative imaging, and inpatient orthopedic trauma follow-up.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	Use when the operative time, complexity, and work substantially exceed typical for open treatment of hip dislocation with associated fractures.

CPT 27227: Open Fixation of Acetabular Fracture

cpt-27200-closed-treatment-coccyx-fracture

CPT 27200: Closed Treatment of Coccyx (Tailbone) Fracture

cpt-27256-closed-hip-dislocation-splint-traction

CPT 27256: Closed Treatment of Hip Dislocation with Splint or Traction

cpt-27230-closed-treatment-femoral-neck-fracture

CPT 27230: Closed Treatment of Femoral Neck Fracture

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

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

cpt-27259-open-surgical-hip-reduction-femoral-shortening

CPT 27259: Open Surgical Hip Reduction with Femoral Shortening

cpt-27268-closed-reduction-femoral-neck-fracture

CPT 27268: Closed Reduction of Femoral Neck/Head Fracture

cpt-27218-open-treatment-posterior-pelvic-ring-fracture-fixation

CPT 27218: Open Treatment of Posterior Pelvic Ring Fracture

cpt-27253-open-treatment-hip-joint-dislocation-no-fixation

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

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

CPT 27246: Closed Treatment of Greater Trochanteric Femur Fracture

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Taxonomy Code	Specialty	Notes
207X00000X	Orthopaedic Surgery	Primary specialty performing hip open reduction and fracture fixation.
2080P0206X	Trauma Surgery	Orthopedic trauma surgeons or trauma specialists involved in complex pelvic/acetabular injury care.
208600000X	General Surgery	May participate in polytrauma management and coordination of care.
2085R0202X	Physical Medicine & Rehabilitation	Involved in postoperative rehabilitation planning and functional recovery.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`S73.001A`	Unspecified dislocation of right hip, initial encounter	Represents traumatic hip dislocation requiring reduction; used when side and specifics are confirmed.
`S73.002A`	Unspecified dislocation of left hip, initial encounter	Represents traumatic hip dislocation on the left side for initial encounter.
`S32.405A`	Unspecified fracture of acetabulum, right side, initial encounter for closed fracture	Common acetabular wall fracture associated with hip dislocation requiring fixation.
`S32.404A`	Unspecified fracture of acetabulum, left side, initial encounter for closed fracture	Left-sided acetabular fracture commonly associated with posterior hip dislocation.
`S72.051A`	Fracture of head and neck of right femur, initial encounter for closed fracture	Femoral head involvement may necessitate repair or fixation during open treatment.
`S72.052A`	Fracture of head and neck of left femur, initial encounter for closed fracture	Left femoral head fracture commonly coexists with dislocation and influences surgical approach.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`27045`	Open treatment of acetabular fracture, anterior column, posterior column or both, with or without internal fixation	May be used when formal acetabular open reduction and internal fixation is required in addition to hip reduction and femoral head repair.
`27220`	Closed treatment of hip dislocation; without anesthesia	Sometimes performed initially in the ED as a closed reduction attempt prior to open treatment.
`27235`	Arthrotomy, hip, with or without removal of loose body (e.g., osteochondral fragments)	May be performed to remove intra-articular fragments contributing to irreducible dislocation.
`20690`	Application of external fixation device (except fingers or toes)	Used when temporary external fixation is applied for pelvis/hip stabilization in polytrauma prior to definitive open fixation.
`99024`	Postoperative follow-up visit global period (by surgeon)	Used for documented postoperative follow-up related to the surgical global period.

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