Adult Reconstructive Orthopedics in the ASC: Joint Replacement CPT Codes
Adult reconstructive orthopedics covers the surgical replacement and revision of major weight-bearing joints, mainly the hip and knee. In an Ambulatory Surgery Center, this work centers on the joint replacement CPT family in the 27125 to 27447 range, including total knee arthroplasty (27447) and total hip arthroplasty (27130).
Whether Medicare pays for a specific joint procedure in an ASC depends on the CMS payment addenda. Codes on Addendum AA are on the ASC Covered Procedures List, meaning Medicare pays them in an ASC, while codes on Addendum EE are excluded from ASC payment. The DataLily procedure library tracks CPT-specific prior-authorization and documentation requirements for these codes.
Ortho – Adult Reconstructive codes(1–60 of 138)
- 27447Total knee arthroplasty
- 27130Total hip arthroplasty
- 27446Revision of knee joint
- 27125Partial hip replacement
- 27132Total hip arthroplasty
- 27134Revise hip joint replacement
- 27137Revise hip joint replacement
- 27138Revise hip joint replacement
- 27140Transplant femur ridge
- 27146Incision of hip bone
- 27147Revision of hip bone
- 27151Incision of hip bones
- 27156Revision of hip bones
- 27158Revision of pelvis
- 27161Incision of neck of femur
- 27165Incision/fixation of femur
- 27170Repair/graft femur head/neck
- 27175Treat slipped epiphysis
- 27176Treat slipped epiphysis
- 27177Treat slipped epiphysis
- 27178Treat slipped epiphysis
- 27179Revise head/neck of femur
- 27181Treat slipped epiphysis
- 27185Revision of femur epiphysis
- 27187Reinforce hip bones
- 27197Clsd tx pelvic ring fx
- 27198Clsd tx pelvic ring fx
- 27200Treat tail bone fracture
- 27202Treat tail bone fracture
- 27220Treat hip socket fracture
- 27222Treat hip socket fracture
- 27226Treat hip wall fracture
- 27227Treat hip fracture(s)
- 27228Treat hip fracture(s)
- 27230Treat thigh fracture
- 27232Treat thigh fracture
- 27235Treat thigh fracture
- 27236Treat thigh fracture
- 27238Treat thigh fracture
- 27240Treat thigh fracture
- 27244Treat thigh fracture
- 27245Treat thigh fracture
- 27246Treat thigh fracture
- 27248Treat thigh fracture
- 27250Treat hip dislocation
- 27252Treat hip dislocation
- 27253Treat hip dislocation
- 27254Treat hip dislocation
- 27256Treat hip dislocation
- 27257Treat hip dislocation
- 27258Treat hip dislocation
- 27259Treat hip dislocation
- 27265Treat hip dislocation
- 27266Treat hip dislocation
- 27267Cltx thigh fx
- 27268Cltx thigh fx w/mnpj
- 27269Optx thigh fx
- 27275Manipulation of hip joint
- 27278Arthrd si jt plmt iartic dev
- 27279Arthrd si jt plmt tartclr dv
Are total joint replacements performed in an ASC?
Yes. Total knee arthroplasty (27447), total hip arthroplasty (27130), and partial hip replacement (27125) can be performed in an Ambulatory Surgery Center, with place of service 24. Whether Medicare pays a specific code in the ASC depends on its status under the CMS ASC payment addenda. Codes on Addendum AA are on the ASC Covered Procedures List and are paid in an ASC, so confirm the current-year addendum status for each code before scheduling.
What CPT codes does adult reconstructive orthopedics use in the ASC?
The core family for adult reconstructive procedures in the ASC is the joint replacement range 27125 to 27447. This includes primary procedures such as total knee arthroplasty (27447) and total hip arthroplasty (27130), partial replacements such as 27125, and revision procedures such as revision of knee joint (27446). We have mapped 138 ASC-relevant CPT codes to this specialty.
How do I know if a joint replacement code is covered in the ASC?
Check the code against the current CMS ASC payment addenda. Codes listed on Addendum AA are on the ASC Covered Procedures List, meaning Medicare pays them in an ASC. Codes on Addendum EE are excluded from ASC payment. Related implants and drugs may be reimbursed as covered ancillary services under Addendum BB. Coverage and prior-authorization rules also vary by commercial payer, so verify the specific code and plan before the case.