Injection · Hip

Injection of contrast material into the hip joint to enable arthrographic X-ray imaging, performed without anesthesia.

Verified May 8, 2026 · 5 sources ↓

Medicare: $232.47
Total RVUs: 6.96
Global, days: 0
Region: Hip

Drawn from CMSAAPCMdclarity

Documentation requirements

What must appear in the operative or office note to support the claim.

Source · Editorial brief grounded in 5 cited references ↓

Specify which hip (left, right, or bilateral) with clinical justification for each side injected
Document the contrast agent used, volume, and route of intra-articular injection
Confirm no anesthesia was administered — note if any local anesthetic was used at injection site only
Record the indication for arthrography (e.g., suspected labral tear, loose body, post-arthroplasty pain evaluation)
Note imaging guidance method used (typically fluoroscopy) and that it was integral to the injection procedure
Document patient tolerance and any immediate adverse response to contrast

Applicable modifiers

Modifiers commonly billed with this code.

Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual

22 Increased complexity 50 Bilateral procedure 52 Reduced services 59 Distinct service 76 Repeat, same physician 77 Repeat, another physician LT Left side RT Right side

What this code covers

Source · Editorial summary grounded in 5 cited references ↓

CPT 27093 covers the injection of contrast agent into the hip joint for arthrography — fluoroscopically guided placement of contrast to opacify the joint space before plain X-ray imaging. No anesthesia is administered. The code covers the injection procedure itself; the arthrography imaging is reported separately.

This code sits in the 000 global period category, meaning no pre- or post-operative services are bundled — each encounter stands alone. Radiologic supervision and interpretation, when performed by the same provider, requires a separate radiology code. If imaging is performed by a different provider, split billing with modifier 26 on the imaging component applies.

Lateral or bilateral designation matters here. Always append LT or RT when injecting a single hip. Modifier 50 is appropriate only when both hips are injected in the same session — document the clinical indication for bilateral arthrography separately for each side. NCCI bundling rules prohibit separate reporting of fluoroscopic guidance when it is already integral to the arthrographic procedure.

RVU & reimbursement

Component RVUs and Medicare national rate. Actual payment varies by GPCI locality.

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU	1.27
Practice expense RVU	5.54
Malpractice RVU	0.15
Total RVU	6.96
Medicare national rate	$232.47
Global period	0 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	$232.47

Common denial reasons

The recurring reasons claims for CPT 27093 get rejected.

Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓

Missing laterality — no LT or RT modifier appended when single hip injected
Separate billing of fluoroscopic guidance that is integral to the arthrographic injection
Lack of documented clinical indication supporting arthrography over alternative imaging
Incorrect site-of-service coding when billed in a facility setting without matching facility claim
Modifier 50 used without documentation of bilateral medical necessity for both hips

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 5 cited references ↓

01Does 27093 include fluoroscopy, or is that billed separately?

Fluoroscopy used to guide the injection is considered integral to the arthrographic procedure under NCCI policy. Do not separately bill a fluoroscopy code for guidance during the injection itself.

02How do I bill when the injecting physician and the radiologist interpreting the images are different providers?

The injecting physician bills 27093 without a modifier for the procedural component. The radiologist bills the arthrography imaging code with modifier 26 for the professional interpretation only. If one provider performs both, they bill both codes without modifier 26.

03Can I bill 27093 bilaterally with modifier 50?

Yes, if both hips are injected in the same session, append modifier 50 and document separate clinical indications for each side. Single-line bilateral billing with modifier 50 is standard for physician claims; ASCs report two lines with LT and RT.

04What is the global period for 27093, and does it affect same-day E/M billing?

The global period is 000 — zero days. There are no bundled pre- or post-op visits. A same-day E/M for a separate, distinct problem can be billed with modifier 25, but the visit must reflect a medically necessary service beyond the decision to perform the injection.

05Is a contrast agent billed separately from 27093?

The contrast material itself may be separately billable using the appropriate HCPCS supply code (e.g., A9585 for gadopentetate dimeglumine in an MR arthrogram context). Verify with your MAC and payer contracts — some payers bundle supply costs into the procedure.

06When is modifier 59 appropriate with 27093?

Use modifier 59 if 27093 is billed on the same date as another procedure that would otherwise trigger an NCCI bundling edit, and the injection was performed at a distinct anatomic site or in a separate session. Do not use 59 to bypass a bundle that legitimately applies.

Sources & references

Editorial content was developed using the following public sources. Last verified May 8, 2026.

Mira AI Scribe

Mira's AI scribe captures the hip side injected, contrast agent and volume, absence of anesthesia, imaging guidance method, and the clinical indication driving the arthrogram. That specificity prevents the two most common denials: missing laterality and unsupported medical necessity. Notes that omit the clinical reason for choosing arthrography — rather than MRI or CT alone — are the primary audit flag for this code.

See how Mira captures CPT 27093 documentation