Open arthrotomy of the hip joint for exploration and removal of loose bodies or foreign material
Verified May 8, 2026 · 6 sources ↓
- Medicare
- $893.47
- Total RVUs
- 26.75
- Global, days
- 90
- Region
- Hip
Documentation requirements
What must appear in the operative or office note to support the claim.
Source · Editorial brief grounded in 6 cited references ↓
- Named surgical approach (e.g., anterolateral, posterior, Smith-Petersen) — not just 'standard approach'
- Description of the loose body or foreign material including size, number, location within the joint, and composition if identifiable
- Confirmation that the joint capsule was incised and direct intra-articular inspection was performed
- Intraoperative findings beyond the primary indication — document all pathology encountered even if not separately coded
- Medical necessity narrative linking imaging or clinical findings to the decision for open rather than arthroscopic approach
- Whether the procedure was planned or an unplanned return to the OR within a prior global period (drives modifier 78 vs. 79)
Applicable modifiers
Modifiers commonly billed with this code.
Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual
What this code covers
Source · Editorial summary grounded in 6 cited references ↓
27033 covers an open hip arthrotomy in which the surgeon incises the joint capsule, directly inspects the hip joint space, and removes loose bodies, foreign material, or other intra-articular debris. This is a formal open procedure — not arthroscopic. The exposure required to fully access the hip joint and retrieve loose or migrated material drives the substantial work value.
The 90-day global period means the operative visit, the procedure itself, and all routine post-op care through day 90 are bundled. Any E/M visit in that window for an unrelated problem requires modifier 24. If the decision for this open procedure was made at an E/M visit the same day or the day before, append modifier 57 to the E/M — not the surgical code.
The MUE for 27033 is 1 unit per encounter per hip. Bilateral hip exploration on the same date requires modifier 50 on a single line (or LT/RT on separate lines at an ASC). Arthroscopic procedures bundled with this open code are not separately billable per NCCI policy: if an arthroscopic approach converts to open, report only the open code.
RVU & reimbursement
Component RVUs and Medicare national rate. Actual payment varies by GPCI locality.
Source · CMS Physician Fee Schedule, RVU26A · January 2026
| Work RVU | 13.76 |
| Practice expense RVU | 10.08 |
| Malpractice RVU | 2.91 |
| Total RVU | 26.75 |
| Medicare national rate | $893.47 |
| Global period | 90 days |
Payment by site of service
Medicare pays different rates by setting. HOPD typically pays substantially more than ASC for the same procedure.
Source · CMS OPPS Addendum B·ASC HCPCS payment rates·2026
| Setting | Medicare rate (national) |
|---|---|
Office (PFS non-facility) Procedure performed in physician's office | $893.47 |
HOPD (APC 5114) Hospital outpatient department | $7,413.38 |
ASC (PI A2) Ambulatory surgical center (freestanding) | $3,695.53 |
Common denial reasons
The recurring reasons claims for CPT 27033 get rejected.
Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓
- Operative note lacks named approach or describes only 'standard incision,' flagging as insufficient documentation for an open hip procedure
- Arthroscopic loose body removal code billed same-day — NCCI bundles the arthroscopic work when conversion to open occurs; only the open code survives
- Medical necessity denied when imaging or clinical documentation doesn't support open exploration over arthroscopic alternatives
- Modifier 50 billed on two lines with full fee each — bilateral reporting rules differ between Medicare Part B (single-line modifier 50) and ASC (LT/RT on separate lines)
- E/M visit on the same day billed without modifier 25 or 57, triggering global period bundling denial
- Return-to-OR exploration billed without modifier 78 when it falls within the global period of a prior hip procedure
Frequently asked questions
Source · Generated from the editorial pipeline, verified against 6 cited references ↓
01Can 27033 be billed with an arthroscopic hip code on the same day?
02What modifier applies if 27033 is performed during the global period of a prior hip surgery?
03Is modifier 50 appropriate if both hips are explored on the same date?
04How does modifier 22 apply to 27033?
05Can an E/M visit be billed on the same day as 27033?
06What ICD-10 diagnoses most commonly support 27033?
07Does cement spacer removal or replacement map to 27033?
Sources & references
Editorial content was developed using the following public sources. Last verified May 8, 2026.
- 01CMS Physician Fee Schedule 2026
- 02cms.govhttps://www.cms.gov/files/document/04-chapter4-ncci-medicare-policy-manual-2026-final.pdf
- 03eohhs.ri.govhttps://eohhs.ri.gov/sites/g/files/xkgbur226/files/2021-03/mue_data_oph.pdf
- 04aapc.comhttps://www.aapc.com/codes/coding-newsletters/my-orthopedic-coding-alert/hips-help-yourself-to-these-27033-27125-27132-coding-insights-149701-article
- 05aaos.orghttps://www.aaos.org/globalassets/quality-and-practice-resources/coding-and-reimbursement/resident-guide/resident-guide_modifiers.pdf
- 06cgsmedicare.comhttps://www.cgsmedicare.com/medicare_dynamic/j15/partb/ptpb/ptp.aspx
Mira AI Scribe
Mira's AI scribe captures the named surgical approach, the specific description of loose body or foreign material (size, number, intra-articular location), the direct inspection findings, and whether the procedure was a conversion from attempted arthroscopy. That documentation locks down the open-procedure distinction and the medical necessity narrative — the two points most likely to trigger an audit or a down-code to an arthroscopic removal code.
See how Mira captures CPT 27033 documentation