Total hip arthroplasty

What is CPT Code 27130?

Total hip replacement (total hip arthroplasty) — removal of the femoral head and acetabulum and replacement with prosthetic components. Major elective surgery with highly variable pricing across facilities.

The Medicare reimbursement rate shown above is the amount the federal government has determined is a reasonable payment for this service. Hospitals and providers that participate in Medicare have agreed to accept these rates from Medicare patients.

Who typically bills this:Orthopedic surgeon + hospital facility

Common Billing Errors for CPT 27130

• !Hip implant billed at chargemaster rates 3–5x acquisition cost
• !Bilateral hip replacement billed as two separate 27130 codes without the bilateral modifier (-50) discount
• !Blood transfusions during surgery billed at supply rates far above the actual blood bank cost

Red Flags on Your Bill

Negotiation Tips for CPT 27130

1. 1Request an itemized bill and negotiate the implant line item specifically — hospitals routinely mark up implants
2. 2If both hips were replaced in the same session, the second side should be billed at a reduced rate
3. 3Consider bundled payment programs or centers of excellence if you have commercial insurance

Codes That Often Appear With This One

These CPT codes commonly appear on the same bill. Review each one to spot potential bundling errors or duplicate charges.

Found CPT 27130 on Your Bill?

If you see CPT code 27130 on a hospital or medical bill, compare the charged amount to the Medicare rate above. If your bill shows a significantly higher charge, you may have grounds to negotiate.

1. Note the amount charged for CPT 27130 on your itemized bill
2. Compare it to the Medicare rate above — calculate the markup
3. Call the billing department and use the Medicare rate as your anchor:“I see CPT code 27130 billed at [amount]. The Medicare rate for this procedure is $1,288.69. I'd like to discuss a fair adjustment.”