Closed reduction of a dislocated hip prosthesis performed under regional or general anesthesia, without surgical incision.

Verified May 8, 2026 · 5 sources ↓

Medicare: $557.80
Work RVU: 7.59
Global, days: 90
Region: Hip

Drawn from AAPCKzanowFindacodeCMS

Documentation requirements

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

Source · Editorial brief grounded in 5 cited references ↓

Confirm the patient has a prior hip arthroplasty — document implant type and original surgery date
Specify the anesthesia type used (regional vs. general) — this is the defining distinction from 27265
Document reduction technique: traction method, leg positioning, number of attempts made
Post-reduction imaging confirming successful joint relocation (fluoroscopy or plain X-ray)
State whether the patient is within the global period of a prior procedure and identify the covering or primary surgeon
Note any stabilization device applied (abduction brace, hip orthosis) after reduction

Applicable modifiers

Modifiers commonly billed with this code.

Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual

22 Increased complexity 50 Bilateral procedure 51 Multiple procedures 58 Staged or related 76 Repeat, same physician 77 Repeat, another physician 78 Unplanned return — related 79 Unrelated during global LT Left side RT Right side

What this code covers

Source · Editorial summary grounded in 5 cited references ↓

CPT 27266 covers closed (non-incisional) manipulation to relocate a dislocated total or partial hip arthroplasty. The distinguishing factor from 27265 is anesthesia: 27266 requires regional or general anesthesia, placing the procedure in an OR or procedure room with an anesthesiologist present. The surgeon uses manual traction and rotation techniques to seat the femoral head component back into the acetabular cup, confirmed by fluoroscopy or post-reduction radiograph.

This code sits squarely in post-arthroplasty complication territory. It is not used for traumatic hip dislocation in a native joint — that's a different code family. If the closed reduction fails and the surgeon proceeds to open reduction in the same operative session, 27266 is replaced by the open reduction code; do not bill both. If the patient redislocates on a different day within the global period of the original arthroplasty, append modifier 78. Multiple unsuccessful reduction attempts in a single OR session still yield one unit of 27266 — add modifier 22 if the work was substantially greater than typical.

The 90-day global period applies. Subsequent dislocations managed in the ER without anesthesia are not separately reportable under Medicare rules during the global period. When a covering physician performs the reduction, modifier 78 still applies if the patient is in the original surgeon's global period.

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 (7.59) is the surgeon's own effort — the figure physician pay and productivity targets are built on. The total RVU (16.7) adds practice overhead and malpractice, and is what drives the Medicare payment below.

Work RVU	7.59
Practice expense RVU	7.49
Malpractice RVU	1.62
Total RVU	16.7
Medicare national rate	$557.80
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	$557.80
HOPD (APC 5112) Hospital outpatient department	$1,642.82
ASC (PI A2) Ambulatory surgical center (freestanding)	$872.87

Common denial reasons

The recurring reasons claims for CPT 27266 get rejected.

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

Missing anesthesia documentation — payers will downcode to 27265 if regional or general anesthesia is not explicitly documented
Modifier 78 omitted when procedure falls within the global period of the original arthroplasty
Billing 27266 and an open reduction code for the same session when closed reduction failed and surgeon converted to open
Billing multiple units for repeated reduction attempts in a single operative session — only one unit is payable per session
Using 27266 for a native (non-prosthetic) traumatic hip dislocation, which maps to a different code

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 5 cited references ↓

01What separates 27266 from 27265?

Anesthesia. 27265 is closed reduction without anesthesia or with local only. 27266 requires regional or general anesthesia. The anesthesia type must be explicitly documented — payers will downcode to 27265 without it.

02If a patient redislocates during the global period of their original THA, what modifier applies?

Modifier 78 — unplanned return to the OR for a procedure related to the original surgery. The original surgeon's global period governs, even if a covering physician performs the reduction.

03The surgeon made three closed reduction attempts before succeeding. How many units of 27266 do I bill?

One unit. Multiple attempts in a single operative session are not billed separately. If the extra attempts added substantial work, append modifier 22 and document the additional time and effort in the operative note.

04The patient had three separate dislocation episodes on three different days. How is each coded?

The first episode gets 27266 with modifier 78 (within the global period). Each subsequent separate episode on a different day is billed as 27266 with modifier 76 (repeat procedure by same physician). Each requires its own operative note.

05Closed reduction failed and the surgeon converted to open reduction in the same OR session. Can I bill both 27266 and the open reduction code?

No. When the surgeon converts to open reduction, bill only the open reduction code. Unsuccessful closed attempts are not separately reportable.

06A covering physician reduced the dislocated hip. Does modifier 78 still apply if the patient is in the original surgeon's global period?

Yes. Modifier 78 travels with the procedure, not the surgeon. The covering physician appends modifier 78 because the patient remains in the global period established by the original arthroplasty.

07Is 27266 billable when a hip dislocation is reduced in the ER without anesthesia during the global period?

No, not under Medicare rules. A post-arthroplasty dislocation managed in the ER without regional or general anesthesia during the global period is not separately reportable. 27266 specifically requires anesthesia.

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 anesthesia type (regional vs. general), the number of reduction attempts, post-reduction imaging confirmation, and whether the patient is within the global period of a prior arthroplasty. It also flags when a covering physician performed the reduction — the detail that determines whether modifier 78 is required. That prevents the two most common denials on this code: missing anesthesia documentation and a dropped global-period modifier.

See how Mira captures CPT 27266 documentation