Conversion of a previously operated hip — any prior surgery except total hip arthroplasty — to a complete total hip arthroplasty, replacing both femoral and acetabular components, with or without bone graft.
Verified May 8, 2026 · 7 sources ↓
- Medicare
- $1,504.04
- Total RVUs
- 45.03
- Global, days
- 90
- Region
- Hip
Documentation requirements
What must appear in the operative or office note to support the claim.
Source · Editorial brief grounded in 7 cited references ↓
- Operative report from the prior hip surgery confirming it was not a total hip arthroplasty
- Pre-operative documentation of indication: AVN, failed fracture fixation, non-union, malunion, or other covered diagnosis
- Radiographic evidence (X-ray or advanced imaging) showing joint degeneration, hardware failure, or structural abnormality
- Conservative treatment history or documented rationale for why conservative measures were not appropriate
- Named surgical approach (e.g., posterior, anterolateral, direct anterior) — generic 'standard approach' flags audits
- Identification of graft type if autograft or allograft was used, including harvest site for autograft
- Implant documentation: manufacturer, model, lot number, and FDA class for femoral and acetabular components
- For Medicare inpatient cases: documented medical necessity for inpatient level of care, not just the procedure itself
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 ↓
CPT 27132 applies when a patient with a prior hip surgery (hemiarthroplasty, fracture fixation, osteotomy, core decompression, or other non-THA procedure) undergoes conversion to a full total hip arthroplasty. Both the femoral stem and acetabular component are implanted. Autograft or allograft may be used and is included in the code — don't unbundle bone graft separately.
The critical distinction from 27130 (primary THA) is prior surgical history at that hip. If the patient had only a diagnostic arthroscopy or aspiration, that likely doesn't qualify as the type of prior surgery that triggers 27132 — document the prior procedure explicitly and confirm it altered anatomy or implanted hardware. Core decompression for AVN is a contested edge case; some payers accept 27132, others default to 27130. Get the prior operative report and address it in your pre-op note.
The 90-day global period covers all routine post-op care through day 90. Unrelated E/M visits in that window need modifier 24. A staged or planned return to the OR for a related issue requires modifier 78; an unrelated procedure in the global needs modifier 79. CMS LCD L36573 (Noridian) and associated billing article A57683 govern Medicare medical necessity. Devices must be FDA class II or III under 21 CFR Part 888.
RVU & reimbursement
Component RVUs and Medicare national rate. Actual payment varies by GPCI locality.
Source · CMS Physician Fee Schedule, RVU26A · January 2026
| Work RVU | 25.05 |
| Practice expense RVU | 14.67 |
| Malpractice RVU | 5.31 |
| Total RVU | 45.03 |
| Medicare national rate | $1,504.04 |
| 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 | $1,504.04 |
HOPD (APC 5115) Hospital outpatient department | $13,116.76 |
ASC (PI J8) Ambulatory surgical center (freestanding) | $9,707.30 |
Common denial reasons
The recurring reasons claims for CPT 27132 get rejected.
Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓
- Billed as 27132 but prior surgery was a total hip arthroplasty — should be a revision code (27134–27138)
- No documentation of a qualifying prior hip surgery, causing payer to downcode to 27130
- Medical necessity denied because conservative treatment trial is undocumented or inadequately described
- ICD-10 diagnosis code does not map to the covered indications list under the applicable MAC LCD
- Inpatient admission not supported as medically necessary — outpatient-appropriate patient billed under Part A
- Bone graft billed separately when it is bundled into 27132
Frequently asked questions
Source · Generated from the editorial pipeline, verified against 7 cited references ↓
01What's the difference between 27132 and 27130?
02Does core decompression for AVN count as prior surgery for 27132?
03Can I bill bone graft separately with 27132?
04What modifiers apply if I need to return to the OR during the 90-day global?
05Is 27132 ever billed with modifier 22?
06What ICD-10 codes support 27132 for Medicare?
07What's the global period for 27132 and what does it cover?
Sources & references
Editorial content was developed using the following public sources. Last verified May 8, 2026.
- 01cms.govhttps://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdid=36573&ver=15
- 02cms.govhttps://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=57683
- 03cms.govhttps://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=59811
- 04cms.govhttps://www.cms.gov/httpswwwcmsgovresearch-statistics-data-and-systemsmonitoring-programsmedicare-ffs-compliance/2a232-total-hip-arthroplasty-medical-necessity-and-documentation-requirements
- 05openpayer.comhttps://www.openpayer.com/billing-codes/27132-conversion-of-previous-hip-surgery-to-total-hip
- 06aahks.orghttps://www.aahks.org/practice-resources/coding-resource-center/
- 07CMS Physician Fee Schedule 2026
Mira AI Scribe
Mira's AI scribe captures the prior hip surgery type and date from dictation, the named surgical approach, both component details (femoral and acetabular), graft use, and the clinical indication driving conversion. That documentation prevents the two most common denials: payers downcoding to 27130 because prior surgery isn't specified, and medical necessity rejections when conservative care history is absent from the operative note.
See how Mira captures CPT 27132 documentation