Surgical · Hip

Passive manipulation of the hip joint performed under general anesthesia to break up fibrous and scar tissue, restore range of motion, and relieve pain.

Verified May 8, 2026 · 7 sources ↓

Medicare: $178.69
Total RVUs: 5.35
Global, days: 10
Region: Hip

Drawn from CMSUhcproviderBluecrossmaNIHAAPC

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 general anesthesia was used — the code requires it; MAC or local anesthesia does not satisfy this requirement
Document the indication: name the condition causing restricted motion (e.g., post-arthroscopy pericapsular scarring, post-arthroplasty stiffness, ankylosis)
Record pre- and post-manipulation range of motion measurements to support medical necessity
If billed same-day with a hip arthroscopy code, document that manipulation was performed on the contralateral hip with laterality clearly stated in the operative note
Note any prior conservative treatment (physical therapy, injections) that failed before proceeding to manipulation under anesthesia
Anesthesiologist or CRNA involvement and anesthesia type should be documented in the anesthesia record and referenced in the operative note

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 50 Bilateral procedure 51 Multiple procedures 59 Distinct service 76 Repeat, same physician 77 Repeat, another physician AS PA/NP/CNS assistant LT Left side RT Right side

What this code covers

Source · Editorial summary grounded in 7 cited references ↓

CPT 27275 covers hip joint manipulation requiring general anesthesia — not a chiropractic-style adjustment, but a forcible passive ranging of the hip performed in an OR or ASC setting with an anesthesiologist present. The goal is disrupting pericapsular adhesions and scar tissue that have restricted motion, most commonly following hip arthroscopy, hip arthroplasty, or prolonged immobilization. The procedure is outpatient; patients bear weight as tolerated immediately and are typically started on physical therapy the same day to preserve the motion gained.

A critical NCCI bundling rule governs this code: when 27275 is performed on the same hip during the same session as a related arthroscopic or open hip procedure, it is not separately reportable. Specifically, CMS NCCI Chapter 4 states that manipulation under anesthesia performed to assess range of motion or for any other purpose during another anatomically related procedure is bundled into that procedure. The CCI edits list 27275 as a column-2 code for hip arthroscopy codes 29914, 29915, and 29916 — the only scenario where both are billable is when the manipulation is performed on the contralateral hip. Use modifier 59 or LT/RT laterality modifiers to document that distinction.

The 010 global period means post-op care runs through day 10. Any E/M services unrelated to the manipulation during that window need modifier 24. Because multiple payers — including UnitedHealthcare — apply medical necessity criteria and may require prior authorization for inpatient cases, verify authorization before scheduling in an inpatient setting. Outpatient cases are generally not subject to prior auth under most commercial products, but confirm at the plan level.

RVU & reimbursement

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

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU	2.26
Practice expense RVU	2.63
Malpractice RVU	0.46
Total RVU	5.35
Medicare national rate	$178.69
Global period	10 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	$178.69
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 27275 get rejected.

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

Bundled into same-session hip arthroscopy (29914, 29915, 29916) on the same side — modifier 59 or laterality modifiers required to unbundle when contralateral
Medical necessity not established — payers require documented failure of conservative care and objective range-of-motion deficit before approving manipulation under anesthesia
Missing general anesthesia documentation — some claims are denied when operative notes do not explicitly confirm general anesthesia was administered
Prior authorization not obtained for inpatient-setting cases — required by most payers when the procedure is performed in an inpatient hospital
Wrong-laterality or missing laterality modifier when billing bilateral cases — modifier 50 or separate LT/RT lines required depending on site of service (facility vs. ASC)

Frequently asked questions

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

01Can I bill 27275 with hip arthroscopy codes 29914, 29915, or 29916?

Only if the manipulation was performed on the opposite hip. NCCI edits list 27275 as a column-2 code for all three arthroscopy codes. Same-side, same-session billing is not separately reportable. Contralateral cases require LT/RT modifiers to show distinct anatomic sites.

02Does 27275 require general anesthesia specifically, or will MAC or spinal anesthesia qualify?

The code descriptor specifies general anesthesia. MAC alone does not satisfy the requirement. If the operative or anesthesia record documents only monitored anesthesia care, the claim is at risk for denial or audit. Spinal or epidural anesthesia is not explicitly addressed by CMS for this code — document the anesthesia type exactly as administered and confirm with your payer.

03What is the global period for 27275 and what does it include?

27275 carries a 010 global period — 10 days. That covers the day of surgery and routine post-op visits through day 10. E/M services unrelated to the manipulation during that window require modifier 24. A new, unrelated surgical procedure in the global window requires modifier 79.

04Is prior authorization required for 27275?

It depends on the setting and the payer. Inpatient cases require precertification from most commercial payers. Outpatient cases are generally not subject to prior auth under standard commercial products, but Medicare Advantage plans may apply their own criteria. Always verify at the individual plan level before scheduling.

05How do I bill 27275 when both hips are manipulated in the same session?

For physician billing, append modifier 50 on a single line. For ASC billing, report two lines — one with modifier LT and one with modifier RT. The NCCI manual distinguishes ASC reporting from the standard modifier 50 requirement that applies to physician claims.

06What ICD-10 codes are typically accepted with 27275?

Post-procedural joint stiffness codes (M96.xx), ankylosis codes (M24.65x for hip), and contracture codes (M24.55x) are the most common supporting diagnoses. Pericapsular scarring following hip arthroscopy or arthroplasty maps to M96.89 or the specific post-procedural complication code. Confirm that the diagnosis code matches the documented indication — generic pain codes alone are frequently challenged on medical necessity 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 anesthesia type, the clinical indication, laterality, and pre- and post-manipulation range of motion measurements directly from the surgeon's dictation. That prevents the two most common denials: missing confirmation of general anesthesia and absent objective ROM documentation that payers use to adjudicate medical necessity.

See how Mira captures CPT 27275 documentation