Summary & Overview
CPT 27132: Conversion to Total Hip Arthroplasty
CPT 27132 covers conversion of prior hip surgery to a total hip arthroplasty, a major reconstructive procedure that addresses failed or inadequate previous hip operations by implanting a total hip prosthesis. Nationally, this code is critical for orthopedic surgeons, hospital billing teams, and payers because it captures a complex, resource-intensive surgery commonly performed in inpatient and ambulatory surgical center settings. Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
Readers will find a concise reference to the clinical scope of CPT 27132, typical sites of service, and the common clinical indications that prompt conversion to total hip arthroplasty. The publication outlines how this code interacts with related surgical services and highlights common billing considerations such as typical modifiers and associated ICD-10 diagnoses. It also summarizes comparable CPT entries used in hip revision and osteotomy procedures to clarify coding distinctions.
Intended as a practical briefing, the content provides benchmarks for coding context, payer coverage landscape, and clinical framing without offering treatment recommendations. Where specific service-line or local policy details are unavailable, the publication notes that data is not available in the input.
CPT Code Overview
CPT 27132 describes the conversion of a previous hip surgery to a total hip arthroplasty, with or without autograft or allograft. This procedure involves removing, revising, or converting prior hip hardware or constructs and implanting a total hip prosthesis to restore hip joint function.
Service Type: Repair, Revision, and/or Reconstruction Procedures on the Pelvis and Hip Joint
Typical Site of Service: Hospital inpatient or ambulatory surgical center
Clinical & Coding Specifications
Clinical Context
A patient with prior hip surgery (for example, internal fixation or an earlier partial arthroplasty) presents with progressive pain, decreased joint function, implant failure, loosening, infection, or tumor involvement of the hip. Preoperative assessment includes history, physical exam, radiographs, CT or MRI as indicated, labs including inflammatory markers and infection workup, and medical clearance. The surgical workflow typically includes removal or conversion of the existing hardware or partial prosthesis, preparation of the acetabulum and femur, and placement of a total hip prosthesis; autograft or allograft may be used as needed for bone loss. Postoperative care includes inpatient or ambulatory surgical center monitoring, pain control, DVT prophylaxis, physical therapy, and follow-up imaging and clinic visits.
Coding Specifications
-
Modifier
LT(Left side): Used when the procedure is performed on the left hip. -
Modifier
RT(Right side): Used when the procedure is performed on the right hip. -
Modifier
22(Increased Procedural Services): Used when documentation supports substantially greater work than typically required for the procedure; documentation must clearly describe the reasons for increased effort and time. -
Modifier
78(Unplanned Return to the Operating/Procedure Room): Used when the patient returns to the operating room for a related procedure during the global period; documentation must support the unplanned nature and relatedness.
Provider Taxonomies
| Taxonomy Code | Specialty Name |
|---|---|
207X00000X | Orthopaedic Surgery |
207XS0114X | Orthopaedic Surgery of the Spine |
207XX0004X | Adult Reconstructive Orthopaedic Surgery |
Related Diagnoses
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C40.21— Malignant neoplasm of long bones of right lower limbClinical relevance: Tumor involvement of proximal femur or surrounding bone can necessitate conversion to total hip arthroplasty as part of oncologic resection or reconstruction.
-
C40.22— Malignant neoplasm of long bones of left lower limbClinical relevance: Same relevance as
C40.21for left-sided disease. -
C47.21— Malignant neoplasm of peripheral nerves of right lower limb, including hipClinical relevance: Tumors affecting periarticular nerves or soft tissues around the hip may require surgical conversion with reconstruction.
-
C47.22— Malignant neoplasm of peripheral nerves of left lower limb, including hipClinical relevance: Same relevance as
C47.21for left-sided disease. -
C49.21— Malignant neoplasm of connective and soft tissue of right lower limb, including hipClinical relevance: Soft tissue malignancy involving the hip region can drive the need for conversion and reconstruction.
-
C49.22— Malignant neoplasm of connective and soft tissue of left lower limb, including hipClinical relevance: Same relevance as
C49.21for left-sided disease. -
D16.21— Benign neoplasm of long bones of right lower limbClinical relevance: Benign bone tumors that compromise the hip joint or previous fixation may prompt conversion to total hip arthroplasty.
-
D16.22— Benign neoplasm of long bones of left lower limbClinical relevance: Same relevance as
D16.21for left-sided disease. -
D21.21— Benign neoplasm of connective and other soft tissue of right lower limb, including hipClinical relevance: Benign soft tissue lesions near the hip may lead to reconstructive procedures including conversion to total hip arthroplasty.
-
D21.22— Benign neoplasm of connective and other soft tissue of left lower limb, including hipClinical relevance: Same relevance as
D21.21for left-sided disease. -
L40.50— Arthropathic psoriasis, unspecifiedClinical relevance: Psoriatic arthropathy affecting the hip joint can lead to degenerative changes or inflammatory destruction requiring conversion to total hip arthroplasty.
Related CPT Codes
| CPT Code | Description |
|---|---|
27091 | Removal of hip prosthesis; complicated, including total hip prosthesis, methylmethacrylate with or without insertion of spacer |
27165 | Osteotomy, intertrochanteric or subtrochanteric including internal or external fixation and/or cast |
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27091is performed when removal of an existing prosthesis or complex explantation is required prior to or as part of conversion to a total hip arthroplasty; it may be performed during the same operative episode when indicated. -
27165is performed for corrective osteotomy of the proximal femur and may be used in cases requiring realignment or reconstruction in conjunction with or as an alternative to conversion to total hip arthroplasty. -
27091is commonly used together with27132when prosthesis removal is complex;27165may be used in select cases for deformity correction rather than primary conversion, depending on clinical indications.
National Reimbursement Benchmarks
Medicare mean allowed rate ($1,524.52) is notably lower than the BUCA (average commercial) mean ($2,160.31), representing a difference of $635.79. Medicare rates cluster near the lower-middle of the commercial range, while BUCA sits closer to mid-range commercial pricing overall.
Rate dispersion (P75 − P25) varies across payers. The tightest dispersion is Medicare at $112.00 (P75 $1,576.00 − P25 $1,464.00). Aetna also shows relatively tight dispersion at $829.00 (P75 $1,716.00 − P25 $887.00) compared with larger spreads for Cigna ($1,638.00) and UnitedHealth Group ($1,721.00). Blue Cross Blue Shield and BUCA have intermediate dispersion at $1,164.65 and $1,207.58 respectively. The table and chart below present the full breakdown.
Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.