Summary & Overview
CPT 27284: Hip Arthrodesis with Autologous Bone Graft
CPT code 27284 denotes surgical hip arthrodesis (fusion) performed with an autologous bone graft. The procedure is used to stabilize the hip joint and eliminate pain by creating a bony fusion between hip articulating surfaces. This code matters nationally because hip arthrodesis, while less common than joint replacement, remains a critical option for complex cases where reconstruction or arthroplasty is unsuitable.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context for CPT code 27284, typical sites of service, and how this service is classified for billing purposes. The publication outlines common billing considerations and related code groupings, presents national benchmarks where available, and summarizes relevant policy or coverage themes that affect prior authorization and claims processing.
This executive summary prepares clinicians, coding professionals, and policy analysts to understand where CPT code 27284 fits in surgical orthopedics, which payers commonly adjudicate claims for this service, and what operational and policy topics to expect in the detailed sections that follow. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 27284 describes arthrodesis (fusion) of the hip joint using a bone graft harvested from another site on the patient (autograft). The procedure is a surgical orthopedic intervention aimed at eliminating motion at the hip joint to relieve pain or stabilize the joint.
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Service type: Surgical orthopedic procedure — hip arthrodesis with autologous bone graft
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Typical site of service: Hospital inpatient or hospital outpatient surgical setting; may also be performed in an ambulatory surgery center depending on clinical circumstances
Clinical & Coding Specifications
Clinical Context
A typical patient is a 52-year-old laborer with advanced post-traumatic osteoarthritis of the hip or symptomatic femoral head collapse after avascular necrosis who has failed conservative care including activity modification, analgesics, and physical therapy. The patient reports chronic groin pain, reduced range of motion, and functional limitations. Imaging (plain radiographs and CT or MRI as indicated) demonstrates end-stage joint destruction or severe deformity not amenable to arthroplasty or when arthroplasty is contraindicated. Preoperative evaluation includes medical clearance, optimization of comorbidities, and consent for autologous bone graft harvest.
In the operating room the orthopedic surgeon performs a hip arthrodesis (CPT 27284) using internal fixation (plates, screws, or intramedullary devices) to achieve osseous fusion of the femoral head/neck to the acetabulum. An autologous bone graft is harvested from the iliac crest or other donor site on the patient and applied to the arthrodesis site to promote union. Intraoperative steps include exposure of the hip joint, debridement of articular cartilage, preparation of fusion surfaces, placement of bone graft, and fixation to maintain position until fusion occurs. Typical postoperative care includes pain control, weight-bearing restrictions per fixation stability, thromboprophylaxis, wound checks, serial radiographs to document progression to union, and rehabilitation focusing on gait training and strengthening.
Coding Specifications
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