Surgical transfer of the iliopsoas muscle from the lesser trochanter to the greater trochanter of the femur to restore hip abductor function.

Verified May 8, 2026 · 6 sources ↓

Medicare: $899.15
Total RVUs: 26.92
Global, days: 90
Region: Hip

Drawn from CMSAetnaNIHFastrvu

Documentation requirements

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

Source · Editorial brief grounded in 6 cited references ↓

Operative note must name the specific transfer: iliopsoas to greater trochanter, including approach and fixation technique used.
Preoperative documentation of hip abductor weakness with functional impact — clinical exam findings, gait assessment, or EMG/imaging evidence.
Indication clearly tied to a supported diagnosis (e.g., failed THA abductor mechanism, neurologic deficit, polio sequelae).
Imaging or prior procedure records supporting the reconstructive indication, especially in post-arthroplasty cases.
If performed same-day as THA or revision THA, the note must separately justify the muscle transfer as a distinct surgical necessity beyond routine arthroplasty.

Applicable modifiers

Modifiers commonly billed with this code.

Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual

22 Increased complexity 51 Multiple procedures 57 Decision for surgery 58 Staged or related 59 Distinct service 62 Co-surgeons 74 Discontinued post-anesthesia 78 Unplanned return — related 79 Unrelated during global 80 Assistant surgeon AS PA/NP/CNS assistant LT Left side RT Right side

What this code covers

Source · Editorial summary grounded in 6 cited references ↓

CPT 27110 describes an open procedure in which the iliopsoas tendon is detached from its insertion at the lesser trochanter and rerouted to the greater trochanter, substituting for deficient or absent hip abductor musculature. The indication is typically severe hip abductor weakness — most commonly following failed total hip arthroplasty with abductor mechanism damage, polio sequelae, or neurologic injury. It is not a routine THA adjunct; it's reconstructive salvage.

The 90-day global period applies. All routine follow-up, wound care, and office visits through day 90 are bundled. If a staged or unrelated procedure is performed during that window, append modifier 58 or 79 respectively. An E/M on the same day as surgery requires modifier 57 if the visit drove the decision to operate, or modifier 25 if it was a separately identifiable problem.

Aetna's Hip Arthroplasty CPB lists 27110 as a covered code when selection criteria are met — typically documented abductor deficiency and failure of conservative measures. Expect prior authorization requirements from most commercial payers. ICD-10 diagnosis coding must reflect the specific etiology (abductor muscle weakness, status post THA with complication, etc.); a generic hip pain code will trigger medical necessity denials.

RVU & reimbursement

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

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU	13.43
Practice expense RVU	10.63
Malpractice RVU	2.86
Total RVU	26.92
Medicare national rate	$899.15
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	$899.15
HOPD (APC 5114) Hospital outpatient department	$7,413.38
ASC (PI J8) Ambulatory surgical center (freestanding)	$4,968.76

Common denial reasons

The recurring reasons claims for CPT 27110 get rejected.

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

Medical necessity denied when diagnosis coding is nonspecific — a hip pain code without documented abductor deficiency fails payer criteria.
Bundling denial when billed same-day as THA or revision hip surgery without adequate modifier and documentation of distinct surgical indication.
Prior authorization not obtained — most commercial payers require pre-auth for this reconstructive procedure given its low-volume, high-complexity profile.
Operative note lacks laterality or specifies only 'standard approach,' triggering coding audit and potential downcoding.
Global period violation if a related post-op visit is billed without modifier 24 during the 90-day window.

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 6 cited references ↓

01Can 27110 be billed on the same day as a total hip arthroplasty (27130)?

Yes, but it requires strong operative note justification that the muscle transfer was a separately necessary procedure beyond the scope of standard THA. Append modifier 51 to the secondary code and ensure the note documents the distinct indication. Expect payer scrutiny — some will require appeal with operative records.

02What global period applies to 27110?

90-day global. Routine post-op visits, wound checks, and dressing changes through day 90 are bundled. Bill unrelated problems with modifier 79; staged procedures with modifier 58; and related complications requiring return to the OR with modifier 78.

03Which diagnoses support medical necessity for 27110?

Hip abductor muscle weakness or insufficiency, abductor mechanism failure following THA, sequelae of poliomyelitis affecting the hip, or neurologic deficit causing abductor paralysis. The diagnosis must match the documented clinical picture — a generic M25.5 hip pain code will not support this procedure.

04Is prior authorization typically required?

Yes, for most commercial payers. Aetna's Hip Arthroplasty CPB covers 27110 when selection criteria are met, but that still requires pre-auth submission with clinical documentation of abductor deficiency and failure of conservative treatment. Verify with the specific payer before scheduling.

05How should laterality be reported for 27110?

Append LT or RT to designate the operative side. Do not leave laterality to inference from the diagnosis code alone — audit teams flag operative notes and claims that omit explicit side designation for unilateral hip procedures.

06Can modifier 62 be used if two surgeons perform the transfer together?

Yes. If the procedure genuinely requires two surgeons operating simultaneously — which can occur in complex revision cases — both surgeons bill 27110-62. Each must document their distinct intraoperative role. Co-surgery is not appropriate if one surgeon is simply assisting; use modifier 80 or AS in that scenario.

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 transfer target (lesser trochanter to greater trochanter), surgical approach, fixation method, and the documented indication — typically abductor mechanism failure or neurologic deficit — directly from dictation. That specificity closes the gap that triggers medical necessity denials and audit flags on operative notes that omit the reconstructive rationale or leave laterality unstated.

See how Mira captures CPT 27110 documentation