Surgical transfer of the iliopsoas muscle to the femoral neck to restore lateral hip stability when the native hip abductors are deficient.

Verified May 8, 2026 · 6 sources ↓

Medicare: $840.70
Work RVU: 12.29
Global, days: 90
Region: Hip

Drawn from CMSAAPCAdsc

Documentation requirements

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

Source · Editorial brief grounded in 6 cited references ↓

Clinical documentation of hip abductor weakness or paralysis with functional impact (e.g., Trendelenburg gait, instability)
Imaging or diagnostic workup confirming abductor deficiency or prior muscle/tendon failure
Operative note specifying the transfer route, attachment site on the femoral neck, and fixation technique used
Prior treatment history demonstrating why direct abductor repair or reconstruction was not feasible
Post-op plan and expected functional outcomes tied to the indication documented preoperatively

Applicable modifiers

Modifiers commonly billed with this code.

Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual

22 Increased complexity 51 Multiple procedures 52 Reduced services 58 Staged or related 59 Distinct service 62 Co-surgeons 78 Unplanned return — related 79 Unrelated during global 80 Assistant surgeon LT Left side RT Right side XS Separate structure

What this code covers

Source · Editorial summary grounded in 6 cited references ↓

CPT 27111 describes rerouting the iliopsoas muscle — the primary hip flexor — to the femoral neck as a substitute for weakened or absent hip abductor function. The goal is to restore lateral stability of the hip joint, reducing a Trendelenburg gait pattern in patients where abductor reconstruction or direct repair is not viable. It is most commonly performed in the setting of abductor paralysis from prior surgery, neurologic injury, or failed hip reconstruction.

This is a 90-day global procedure. All routine postoperative care — wound checks, suture removal, and follow-up visits related to the transfer — is included through day 90. Any new problem or unrelated service billed in that window requires modifier 24 (E/M) or modifier 79 (unrelated procedure). Planned staged procedures require modifier 58.

Documentation must establish the functional deficit driving the transfer — imaging, clinical exam findings, and prior treatment history. Operative notes should name the specific attachment site and fixation method used. Payers scrutinize medical necessity heavily on this code given its infrequent use; vague indications or incomplete operative detail are the most common triggers for denial or audit.

RVU & reimbursement

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

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU vs. total RVU

The work RVU (12.29) is the surgeon's own effort — the figure physician pay and productivity targets are built on. The total RVU (25.17) adds practice overhead and malpractice, and is what drives the Medicare payment below.

Work RVU	12.29
Practice expense RVU	10.27
Malpractice RVU	2.61
Total RVU	25.17
Medicare national rate	$840.70
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	$840.70
HOPD (APC 5113) Hospital outpatient department	$3,342.87
ASC (PI A2) Ambulatory surgical center (freestanding)	$1,644.87

Common denial reasons

The recurring reasons claims for CPT 27111 get rejected.

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

Medical necessity not established — no documented abductor deficit or failed conservative/surgical history
Operative note lacks specificity on transfer site and fixation method, triggering coding audit
Missing prior authorization — many commercial and managed Medicaid plans require PA for muscle transfer procedures
Bundling conflict when soft-tissue or tendon procedures billed same-day without modifier 59 or XS to establish separate and distinct service

Frequently asked questions

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

01What is the global period for CPT 27111?

90 days. All routine postoperative visits, wound care, and follow-up related to the iliopsoas transfer are bundled through day 90. Unrelated E/M services need modifier 24; unrelated procedures need modifier 79.

02When is modifier 58 appropriate for 27111?

Use modifier 58 when a staged or related procedure was planned at the time of the original transfer and is performed during the 90-day global period. Do not use modifier 78 for planned staged work — that modifier is reserved for unplanned returns for a related complication.

03Can 27111 and 27110 be billed together?

27110 and 27111 describe different iliopsoas transfer techniques (to the greater trochanter vs. the femoral neck). Billing both for the same hip on the same date is not supported; select the code that matches the attachment site documented in the operative note.

04Is prior authorization typically required for 27111?

Most commercial payers and managed Medicaid plans require PA for muscle transfer procedures. Verify with the specific payer before scheduling — authorization gaps are a leading cause of post-service denial on low-volume reconstructive hip codes.

05What ICD-10 diagnoses support medical necessity for 27111?

Hip abductor weakness or paralysis (e.g., M62.851, G72.89), Trendelenburg gait related to neurologic or post-surgical deficit, and sequelae of prior hip surgery affecting abductor integrity are the most defensible primary diagnoses. Vague unspecified hip pain alone will not support this code.

06How does site of service affect reimbursement for 27111?

HOPD and ASC payment rates differ significantly from the Medicare Physician Fee Schedule facility rate. See the Site of Service comparison table on this page. The professional component RVU is the same regardless of setting, but facility fees vary substantially between HOPD and ASC.

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 functional indication (abductor deficiency, Trendelenburg gait, prior failed repair), the transfer route, the femoral neck attachment site, and the fixation construct from dictation. That specificity prevents the most common audit flag on 27111: an operative note that confirms a muscle was moved but fails to document where it was anchored and why primary abductor repair was not an option.

See how Mira captures CPT 27111 documentation