Current Procedural Terminology (CPT) codes are a standardized, five-digit language used by healthcare providers to document medical procedures and services for billing and administrative purposes. Maintained by the American Medical Association, these codes ensure uniformity in communication between providers, patients, and insurance payers.
The Scope of CPT 27130
The specific code CPT 27130 identifies Total Hip Arthroplasty, commonly known as total hip replacement. The full clinical description is “Arthroplasty, acetabulum and proximal femur (total hip replacement), with or without cement; primary.”
The term “primary” indicates this is the first time the procedure is performed on the hip joint, distinguishing it from revision surgery. The phrase “with or without cement” covers both cemented fixation (using bone cement) and cementless, or press-fit, fixation (allowing bone to grow onto the implant). This precise coding is essential for medical documentation and determining appropriate reimbursement.
Medical Conditions Requiring Total Hip Replacement
The procedure covered by CPT 27130 is required for severe joint damage that limits mobility and causes chronic pain. Osteoarthritis is the most common diagnosis, where protective cartilage wears away, leading to painful bone-on-bone friction, stiffness, and loss of function.
Other inflammatory conditions, such as rheumatoid arthritis, an autoimmune disorder causing joint destruction, can also necessitate replacement. Avascular necrosis (AVN), or osteonecrosis, is another indication, resulting from a loss of blood supply to the femoral head that causes bone tissue to die and collapse.
Severe trauma, such as complex hip or femoral neck fractures, often requires total hip arthroplasty, especially when internal fixation is not possible. When non-surgical treatments like physical therapy and pain medication fail to restore function, total hip replacement becomes the definitive option.
Surgical Steps of the Arthroplasty
Total hip arthroplasty begins with an incision to access the joint, using an anterior, posterior, or lateral approach. After exposing the joint, the surgeon dislocates the femoral head from the acetabulum (hip socket). The damaged femoral head is then removed via a precise osteotomy, or bone cut, at the neck of the femur.
The surgeon then uses reamers on the acetabulum to remove damaged cartilage and shape the socket. A metal shell is secured into this prepared bone bed, and a liner (plastic, ceramic, or metal) is inserted into the shell. Next, the hollow center of the femur is prepared to accept the femoral stem component.
The metallic stem is inserted into the femoral canal, secured either with bone cement or press-fit for cementless fixation. A ceramic or metal ball, acting as the new femoral head, is attached to the top of the stem. This prosthetic ball is placed into the new socket component, completing the hip joint. The surgeon checks stability, range of motion, and leg length before closing the incision.
Expected Post-Surgical Recovery
Recovery begins immediately, with patients encouraged to stand and walk with assistance (such as a walker) on the same day or the day following surgery. This early mobilization helps prevent complications like blood clots and initiates rehabilitation. Pain management is a focus during the initial hospital stay, which often lasts one to three days.
Physical therapy starts soon after the operation, focusing on restoring hip strength and range of motion. Over the first two to six weeks, patients transition from a walker to a cane, increasing mobility and independence. Patients must follow specific hip precautions, avoiding movements like extreme flexion or rotation, to prevent joint dislocation.
Most individuals resume light daily activities within three to six weeks. Full recovery, including a return to non-strenuous work and driving, generally takes six to twelve weeks. Complete restoration of strength and endurance may continue for up to six months or a year. Adhering to the personalized physical therapy regimen and precautions ensures the long-term success of the arthroplasty.