Revision of a total hip arthroplasty involving the acetabular component only, with or without autograft or allograft

Verified May 8, 2026 · 7 sources ↓

Medicare: $1,317.67
Total RVUs: 39.45
Global, days: 90
Region: Hip

Drawn from CMSAAHKSAAPCZimmerbiometCgsmedicare

Documentation requirements

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

Source · Editorial brief grounded in 7 cited references ↓

Specify that only the acetabular component was revised — operative note must distinguish this from a both-component revision (27134)
Document indication for revision: component loosening, instability, wear, periprosthetic fracture, infection, or other failure mode with supporting imaging or clinical findings
Record whether autograft, allograft, or no bone graft was used, and the graft source if applicable
Identify the implant components removed and implanted, including manufacturer, size, and fixation method
Note approach used by name (e.g., posterior, direct anterior, direct lateral) — operative notes that reference only 'standard approach' draw audit scrutiny
If modifier 52 is applied for isolated modular liner revision, document that the shell was retained and only the liner was exchanged
Prior arthroplasty history must be established in the record, confirming this is a revision of an existing THA

Applicable modifiers

Modifiers commonly billed with this code.

Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual

22 Increased complexity 52 Reduced services 58 Staged or related 62 Co-surgeons 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 7 cited references ↓

CPT 27137 covers surgical revision of the acetabular component of a previously placed total hip arthroplasty, with or without the use of bone graft material. This is a component-specific revision — only the socket side is addressed. When both acetabular and femoral components require revision, report 27134 instead. When only the femoral component is revised, use 27138. Selecting the wrong code from this family is a top audit trigger.

If a single modular component of the acetabular construct (for example, only the liner) is revised rather than the entire acetabular assembly, modifier 52 is appended to 27137 to reflect the reduced service. Removal of an existing intra-articular drug-delivery device during the revision is bundled — do not report it separately. If resorbable antibiotic-eluting beads are manually prepared and inserted at the time of surgery, 20704 may be reported alongside 27137.

The 90-day global period means all routine post-op care through day 90 is included in the payment. Services unrelated to the revision billed within that window require modifier 24 (E/M) or modifier 79 (unrelated procedure). A return to the OR for a complication related to the revision bills with modifier 78. Site of service matters: HOPD and ASC carry materially different facility payments — confirm the correct setting is reflected on the claim.

RVU & reimbursement

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

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU	22.13
Practice expense RVU	12.61
Malpractice RVU	4.71
Total RVU	39.45
Medicare national rate	$1,317.67
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	$1,317.67
HOPD (APC 5115) Hospital outpatient department	$13,116.76
ASC (PI J8) Ambulatory surgical center (freestanding)	$8,939.53

Common denial reasons

The recurring reasons claims for CPT 27137 get rejected.

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

Wrong code selected — 27134 billed when only the acetabular component was revised, or 27137 used when both components were addressed
Medical necessity not established — record lacks imaging, clinical findings, or documented conservative management failure supporting the revision
Modifier 52 omitted when only the acetabular liner was exchanged, leading to upcoding flags on audit
Global period conflict — post-op services billed without modifier 24 or 79 within the 90-day global of the index arthroplasty
ICD-10 diagnosis code does not support acetabular-component-specific revision (mismatch between diagnosis and code specificity)

Frequently asked questions

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

01What is the difference between 27134, 27137, and 27138?

27134 = both acetabular and femoral components revised. 27137 = acetabular component only. 27138 = femoral component only. Component specificity in the operative note drives code selection — if both components are touched, 27134 is the correct code regardless of how much work was done on each side.

02When does modifier 52 apply to 27137?

Append modifier 52 when only a modular acetabular liner is exchanged and the shell remains in place. The shell-in, liner-out scenario represents a reduced service compared to full acetabular component revision. Note: facility coders should confirm payer policy on modifier 52 for procedures performed under anesthesia — some payers restrict its use in that context.

03Can 20704 be billed with 27137?

Yes. If resorbable antibiotic-eluting beads are manually prepared separately and inserted into the joint at the time of the acetabular revision, 20704 may be reported alongside 27137. Removal of an existing intra-articular drug-delivery device during the revision is bundled and not separately reportable.

04How does the 90-day global period affect post-op billing?

All routine follow-up for the hip revision through post-op day 90 is included in the 27137 payment. Unrelated E/M visits in that window need modifier 24. Unrelated procedures need modifier 79. A return to the OR for a related complication — such as dislocation or wound dehiscence — bills with modifier 78.

05Is 27137 performed bilaterally?

Bilateral simultaneous acetabular revisions are exceptionally rare, but if performed, professional claims use modifier 50. ASC facility claims report two lines using LT and RT on separate lines. Medicare bilateral payment is typically capped at 150% of the single-procedure rate — verify with the specific payer.

06What ICD-10 codes are typically paired with 27137?

Common pairings include T84.052- (periprosthetic loosening of acetabular component), T84.012- (dislocation), T84.032- (mechanical loosening), and T84.59- (infection/inflammatory reaction). The AAHKS provides a cross-reference document for ICD-10 codes specific to 27137. Diagnosis codes must match the documented indication — a loosening code on a wear-driven liner exchange will trigger review.

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 component-specific nature of the revision from dictation — confirming acetabular-only work, graft use, shell retention or replacement, implant details, and approach — and flags if the note contains language that would support 27134 (both components) instead of 27137. This prevents the most common denial in the 27134/27137/27138 family: code-to-documentation mismatch caught on post-payment audit.

See how Mira captures CPT 27137 documentation