Surgical · Hip

Open revision of the femoral head and/or neck, including procedures to reshape, recontour, or reconstruct the proximal femur outside of a total hip arthroplasty context.

Verified May 8, 2026 · 6 sources ↓

Medicare: $903.83
Total RVUs: 27.06
Global, days: 90
Region: Hip

Drawn from CMSAAPCAAHKSAoassn

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 identify the specific anatomic structures revised — femoral head, femoral neck, or head-neck junction — not just 'proximal femur'
Document the surgical approach by name (e.g., anterior, anterolateral, posterior, surgical hip dislocation) — vague 'standard approach' language draws audits
Record the intraoperative findings that indicated revision, including any prior hardware, deformity, impingement anatomy, or osteonecrosis extent
If modifier 22 is appended, the note must quantify increased complexity — operative time, blood loss, or specific anatomic obstacles that made the case materially harder than typical
ICD-10 diagnosis must support the procedure — avascular necrosis, post-traumatic deformity, CAM/pincer impingement, or malunion staging should be coded with specificity
If performed in context of a prior surgery or hardware removal, document the relationship to prior procedure for global period and modifier 78/79 determinations

Applicable modifiers

Modifiers commonly billed with this code.

Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual

22 Increased complexity 24 Unrelated E/M during global 25 Significant separate E/M 50 Bilateral procedure 51 Multiple procedures 52 Reduced services 57 Decision for surgery 58 Staged or related 59 Distinct service 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 6 cited references ↓

CPT 27179 describes an open surgical revision of the femoral head and/or neck — typically performed to address deformity, post-traumatic malunion, avascular necrosis changes, or femoroacetabular impingement anatomy that cannot be corrected arthroscopically. The procedure involves direct exposure of the proximal femur with osseous work (osteoplasty, recontouring, or structural correction) to the head-neck junction or femoral head itself.

This is a 90-day global code. All routine post-op care from the day before surgery through day 90 is included in the payment — E/M visits, wound checks, and suture removal. Unrelated problems treated during the global period require modifier 24 (E/M) or modifier 79 (unrelated procedure). A same-day significant and separately identifiable E/M requires modifier 25.

Bilaterally performed cases are uncommon but reportable — use modifier 50 (single-line) for professional billing or LT/RT on separate lines for ASC claims. When unusual anatomic complexity or substantially increased operative time materially increases the service, modifier 22 applies with a supporting operative note that documents the specific factors driving added work.

RVU & reimbursement

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

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU	13.62
Practice expense RVU	10.53
Malpractice RVU	2.91
Total RVU	27.06
Medicare national rate	$903.83
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	$903.83
HOPD (APC 5114) Hospital outpatient department	$7,413.38
ASC (PI G2) Ambulatory surgical center (freestanding)	$3,695.53

Common denial reasons

The recurring reasons claims for CPT 27179 get rejected.

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

Medical necessity not established — diagnosis codes lack specificity or don't clearly connect to the need for open femoral head/neck revision
Bundling with a same-day hip procedure where 27179 is the column 2 code and no valid modifier was appended
Modifier 22 claimed without documentation that explains what made the procedure substantially more complex than the baseline descriptor
Global period conflict — post-op E/M billed without modifier 24 when a prior hip procedure's 90-day global is still active
Site-of-service mismatch — procedure billed under facility place of service but claim submitted with non-facility RVU expectations, or vice versa

Frequently asked questions

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

01When does 27179 apply versus an arthroscopic femoral osteoplasty code?

27179 is an open procedure. If the femoral head/neck recontouring is done entirely arthroscopically, code to the appropriate hip arthroscopy code instead. Use 27179 when open exposure — including surgical hip dislocation — is required to complete the osseous work.

02Can 27179 be billed on the same day as a total hip arthroplasty code?

No. Femoral head/neck revision work is included in the THA procedure. Billing 27179 alongside a THA code on the same hip will trigger NCCI bundling edits. The osteoplasty is not separately reportable when a THA is performed at the same encounter.

03What modifier applies if the patient returns for a complication requiring repeat open hip surgery within the 90-day global?

Use modifier 78 if the return procedure is related to the original surgery — for example, managing a wound complication or addressing instability from the same operative site. Modifier 79 applies only when the return procedure is completely unrelated to the original surgery.

04How should billing differ between HOPD and ASC settings for 27179?

The professional fee (surgeon) billing is identical regardless of facility setting. The facility payment differs significantly — see the Site of Service comparison table on this page. The lower ASC rate affects facility revenue; surgeon billing uses the same CPT code and modifiers in both settings.

05Is modifier 50 appropriate for bilateral same-day femoral head/neck revision?

Yes, but it's rare. For professional claims, append modifier 50 to a single line. For ASC facility claims, report on two separate lines with LT on one and RT on the other, each with one unit of service. Document bilateral medical necessity explicitly in the operative report.

06What ICD-10 diagnoses most commonly support 27179?

Avascular necrosis of the femoral head (M87.05x), post-traumatic deformity or malunion of the proximal femur (M84.35x, S72 sequela codes), and femoroacetabular impingement (M25.85x) are the primary supporting diagnoses. Code specificity to laterality is required — unspecified laterality codes increase denial risk.

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 surgical approach by name, specific osseous work performed at the femoral head and neck, intraoperative findings driving the revision (e.g., cam deformity extent, necrotic segment, prior implant involvement), and estimated operative time. That prevents the two most common audit flags on 27179: operative notes that omit named approach and anatomy, and modifier 22 claims with no documented complexity rationale.

See how Mira captures CPT 27179 documentation