Injection · Hip

Injection into the hip joint with anesthesia to introduce contrast material for arthrographic imaging of the hip.

Verified May 8, 2026 · 7 sources ↓

Medicare: $325.66
Total RVUs: 9.75
Global, days: 0
Region: Hip

Drawn from CMSAAPCZhealthpublishingPayerpriceMdclarity

Documentation requirements

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

Source · Editorial brief grounded in 7 cited references ↓

Explicit statement that anesthesia was administered (distinguishes 27095 from 27093 — note type and administration route)
Laterality documented (left, right, or bilateral) to support LT, RT, or modifier 50
Contrast agent name, concentration, and volume injected, with confirmation of intra-articular placement (e.g., positive arthrogram documented)
Image guidance method documented (fluoroscopy is standard) — note that guidance is billed separately and requires its own documentation
Needle type, gauge, and approach trajectory (e.g., anterior approach to femoral head-neck junction) for medical necessity and audit support
Indication for the procedure tied to a supporting ICD-10 diagnosis code (e.g., hip degenerative joint disease, labral pathology)

Applicable modifiers

Modifiers commonly billed with this code.

Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual

22 Increased complexity 24 Unrelated E/M during global 25 Significant separate E/M 50 Bilateral procedure 51 Multiple procedures 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 7 cited references ↓

CPT 27095 covers the injection procedure for hip arthrography performed under anesthesia — typically MAC or local with sedation. The injectate (contrast agent, often combined with therapeutic agents like corticosteroid or local anesthetic) is delivered into the hip joint under image guidance, usually fluoroscopy, to opacify the joint space for diagnostic imaging. The 000 global period means there is no post-op window: the day-of service is the only billable encounter under this code.

The sister code 27093 covers the same injection without anesthesia. Choosing between them is a documentation call — the operative or procedure note must explicitly state that anesthesia was administered. Payers audit this distinction closely. The radiology interpretation (arthrogram imaging) is billed separately; 27095 covers only the injection component, not the read.

This procedure is most commonly performed in an office or outpatient hospital setting. LT and RT modifiers are essential when laterality applies, which it nearly always does for hip injections. If the procedure is performed bilaterally in the same session, modifier 50 applies. Check your MAC's LCD — some contractors have specific contrast-agent and imaging-guidance documentation requirements that go beyond the standard procedure note.

RVU & reimbursement

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

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU	1.46
Practice expense RVU	8.07
Malpractice RVU	0.22
Total RVU	9.75
Medicare national rate	$325.66
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	$325.66

Common denial reasons

The recurring reasons claims for CPT 27095 get rejected.

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

Anesthesia not documented — payer downcodes to 27093 when the note lacks an explicit anesthesia statement
Missing or incorrect laterality modifier — claims without LT or RT are frequently rejected or flagged for hip injection codes
Bundling conflict when fluoroscopic guidance is billed without proper understanding of what 27095 includes versus what requires a separate add-on code
Medical necessity denial when the ICD-10 diagnosis on the claim does not support arthrographic evaluation of the hip
Modifier 50 used without bilateral documentation in the procedure note — payers will reverse bilateral payment if the note only describes a unilateral procedure

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 7 cited references ↓

01What is the difference between 27093 and 27095?

27093 is the hip arthrography injection without anesthesia; 27095 is the same procedure performed with anesthesia. The distinction is entirely documentation-driven — the procedure note must state that anesthesia was used. Payers will downcode 27095 to 27093 if the note is silent on anesthesia.

02Does 27095 include the fluoroscopic guidance?

No. 27095 covers the injection procedure only. Fluoroscopic guidance is reported separately (e.g., with the appropriate radiology guidance code). The arthrogram imaging interpretation is also billed separately. Confirm your MAC's rules on what is bundled versus separately reportable.

03Do I need a laterality modifier on 27095?

Yes. Use LT for left hip, RT for right hip. For bilateral same-session injections, use modifier 50 and confirm the procedure note documents both sides. Claims submitted without a laterality modifier are a common rejection trigger for hip procedure codes.

04What is the global period for 27095?

The global period is 000, meaning only the day of service is included. There is no pre-op or post-op window. Any E/M service on the same day for a separate, unrelated problem requires modifier 25.

05Can 27095 and a therapeutic injection be billed on the same day for the same hip?

Only if they represent distinct, separately documented procedures. If contrast and therapeutic agents (e.g., corticosteroid, local anesthetic) are injected through the same needle entry in the same session, that is one procedure — 27095. Do not unbundle by billing a separate injection code for the therapeutic component of the same encounter.

06Which settings is 27095 typically performed in?

Most commonly performed in an office (POS 11) or on-campus outpatient hospital (POS 22) setting. There are no ASC or HOPD facility payment amounts published for this code under the 2026 fee schedules — verify with your MAC before scheduling in those settings.

Sources & references

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

Mira AI Scribe

Mira's AI scribe captures anesthesia type and administration, approach description, contrast agent and volume, confirmation of intra-articular placement, and explicit laterality from the physician's dictation. This prevents the most common denial path for 27095 — downcoding to 27093 because the note was silent on anesthesia — and ensures laterality modifiers are assigned correctly at charge entry.

See how Mira captures CPT 27095 documentation