Joint replacement · Hip

27125

Surgical removal of the femoral head with replacement by a prosthetic implant; the native acetabulum is left in place (hemiarthroplasty).

Verified May 8, 2026 · 7 sources ↓

Medicare
$1,035.76
Total RVUs
31.01
Global, days
90
Region
Hip
Drawn from CMSAAPCMdclarityAAHKSAAOS

Documentation requirements

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

Source · Editorial brief grounded in 7 cited references ↓

  • Specify the implant type and manufacturer (unipolar vs. bipolar femoral head prosthesis) in the operative note.
  • Document the indication — femoral neck fracture, avascular necrosis, or other pathology — with supporting imaging (X-ray or MRI).
  • Record failed or contraindicated conservative treatment prior to surgical intervention.
  • Note the surgical approach by name (posterior, anterolateral, direct anterior) — audit teams flag notes that say only 'standard approach'.
  • Confirm acetabular cartilage was assessed and left intact; this distinguishes 27125 from 27130.
  • Include pre-op functional status and ambulatory limitations to support medical necessity under applicable LCD criteria.

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 7 cited references ↓

27125 covers hemiarthroplasty of the hip — the femoral head is excised and replaced with a prosthetic component while the acetabular socket remains untouched. This distinguishes it from total hip arthroplasty (27130), where both sides of the joint are replaced. The procedure is most commonly performed for femoral neck fractures in elderly patients or for avascular necrosis where the acetabular cartilage is still viable.

27125 carries a 90-day global period. That window includes the day-before preoperative visit, the surgery itself, and all routine post-op management through day 90. Any E/M service for an unrelated condition during the global requires modifier 24; a separately identifiable E/M on the day of surgery requires modifier 25 appended to the E/M. Staged or unrelated procedures performed during the global need modifier 79.

Site of service matters here. HOPD and ASC payment rates differ substantially — see the Site of Service comparison table on this page. Most payers follow LCD guidance for major joint replacement (Novitas L36007, NGS L36039, WPS L39911, and others) requiring documented failure of conservative management, functional limitation, and imaging confirmation of the pathology. Bilateral hemiarthroplasty same-session is rare but reported with modifier 50; left or right laterality should always be specified with LT or RT.

RVU & reimbursement

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

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU16.22
Practice expense RVU11.36
Malpractice RVU3.43
Total RVU31.01
Medicare national rate$1,035.76
Global period90 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

SettingMedicare rate (national)
Office (PFS non-facility)
Procedure performed in physician's office
$1,035.76
HOPD (APC 5115)
Hospital outpatient department
$13,116.76
ASC (PI J8)
Ambulatory surgical center (freestanding)
$8,652.94

Common denial reasons

The recurring reasons claims for CPT 27125 get rejected.

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

  • Miscoding as 27130 (total hip arthroplasty) when only the femoral component was replaced — payers audit implant invoices.
  • Missing or insufficient medical necessity documentation; LCDs for major joint replacement require evidence of conservative treatment failure or acute fracture indication.
  • Lack of laterality — claims without LT or RT modifiers are routinely rejected or pended by many Medicare contractors.
  • Global period overlap: billing a related E/M or minor procedure within the 90-day window without the appropriate modifier (24, 78, or 79).
  • ICD-10 mismatch — pairing 27125 with a diagnosis that maps more appropriately to total arthroplasty (e.g., severe bilateral OA) triggers medical necessity edits.

Frequently asked questions

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

01What is the difference between 27125 and 27130?
27125 is hemiarthroplasty — only the femoral head is replaced, the acetabulum is left native. 27130 is total hip arthroplasty, replacing both the femoral and acetabular components. Billing 27130 when the acetabulum was not resurfaced is a common overcoding error that triggers payer audits and recoupment.
02Does 27125 require a modifier for laterality?
Yes. Append LT or RT on every claim. Most Medicare contractors and commercial payers require laterality on hip procedures, and missing it is a leading cause of pend or rejection. For rare bilateral same-session cases, use modifier 50 instead.
03What is the global period for 27125, and what does it include?
90-day global. Covered: the day-before pre-op visit, the surgery, and all routine post-op care through day 90. Use modifier 24 for unrelated E/M visits in the global window, modifier 78 for an unplanned return to the OR for a related complication, and modifier 79 for an unrelated surgical procedure during the global.
04Which ICD-10 codes pair with 27125 for Medicare medical necessity?
The strongest pairing is an acute femoral neck fracture (S72.001–S72.099 range) or avascular necrosis (M87.050–M87.059). Degenerative arthritis diagnoses can be used but require documentation that the acetabular cartilage was intact and hemiarthroplasty was the planned approach. Payers cross-reference the diagnosis against implant type.
05Can 27125 and 27130 ever be billed together?
No — not for the same hip. They are mutually exclusive for a single joint. If a planned hemiarthroplasty was converted intraoperatively to a total hip, bill 27130 only and document the intraoperative finding that drove conversion. Modifier 22 may apply if the conversion significantly increased operative time and complexity.
06Is modifier 22 ever appropriate for 27125?
Yes, when the procedure required substantially greater work than typical — for example, a severely displaced or comminuted fracture requiring extended soft-tissue dissection or revision of a prior implant. Attach a cover letter quantifying the additional time and complexity; without it, most payers deny the modifier upcharge automatically.
07What LCD policies govern medical necessity for 27125?
Several MACs maintain LCDs for major joint replacement that cover 27125, including Novitas L36007, NGS L36039, and WPS L39911. Requirements vary slightly by contractor but consistently demand documented functional impairment, imaging confirmation, and — for elective cases — evidence of failed conservative management. Fracture cases are generally exempt from the conservative-treatment requirement.

Mira AI Scribe

The Mira AI Scribe captures the surgical approach by name, implant details (unipolar vs. bipolar, manufacturer), acetabular status, and the primary indication (fracture type, AVN stage, or other pathology) directly from surgeon dictation. That prevents the most common audit flag on 27125: an operative note that doesn't clearly differentiate hemiarthroplasty from total hip arthroplasty, or one that omits implant specifics that payers cross-reference against invoice data.

See how Mira captures CPT 27125 documentation

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