Coding guide for Joint replacement CPT codes - Medical Coding Guide (2024)

Joint replacement is a procedure that involves replacing an injured or ailing joint with an artificial joint, or prosthesis. Joint replacement helps in restoring the mobility and functionality of the joint and relieve pain. When medication and physical therapy fails to alleviate joint pain and dysfunction, total joint arthroplasty is a surgical option to improve joint function and relieve pain.

Osteoarthritis is the main indication for performing the total arthroplasty procedures. Arthroplasty is the most common procedure to perform joint condition of knee, hip and shoulder. Arthroplasty is performed under general or regional anesthesia.

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Knee arthroplasty CPT codes

Knee joint is subdivided into three compartments, medial (inside aspect of the knee), lateral (outside aspect of the knee) and patellofemoral (front of the knee). UKA [also known as partial knee replacement] is performed in one of the knee compartments in which the damaged parts of the knee are replaced. This minimally invasive partial knee replacement may be an option for patients whose arthritis is isolated to either the medial or the lateral compartment of the knee. It is called a partial replacement because only one compartment of the damaged knee is replaced. This typically involves damaged joint or bone tissue in the knee joint, which is replaced with a man-made prosthetic, while the anterior and posterior cruciate ligaments are preserved. The incision for a partial replacement is smaller because of the smaller implants. In addition, UKA may result in less postoperative pain and a shorter recovery period than a TKA because there is less dissection, and therefore, less surgery is required. Although a UKA is less common than a TKA, the physician may recommend it as a more appropriate procedure for the patient because only one compartment of the knee is affected.

Knee joint arthroplasty includes cpt code 27437-27447, 27486, 27487.

27437 Arthroplasty, patella; without prosthesis
27438 with prosthesis
27440 Arthroplasty, knee, tibial plateau;
27441 with debridement and partial synovectomy
27442 Arthroplasty, femoral condyles or tibial plateau(s), knee;
27443 with debridement and partial synovectomy
27445 Arthroplasty, knee, hinge prosthesis (eg, Walldius type)
27446 Arthroplasty, knee, condyle and plateau; medial OR lateral compartment
27447 medial AND lateral compartments with or without patella resurfacing (total knee arthroplasty)

27486 Revision of total knee arthroplasty, with or without allograft; 1 component
27487 femoral and entire tibial component

Hip Arthroplasty CPT codes

Hip arthroplasty includes cpt code 27132, 27125, 27134-27138, 27130. Hip arthroplasty includes unipolar and bipolar hip hemiarthroplasty. and total hip arthroplasty. Hemiarthroplasty code 27125 should not be used to report a partial hip replacement to treat a traumatic hip fracture. For a prosthetic placed following hip fracture use cpt code 27236.

Use codes 27134-27318 when a revision surgical procedure (involving the joint hardware) is performed after an initial arthroplasty. To illustrate, if femoral and acetabular components were inserted and, at a later date, the patient requires a single stage hip revision, code 27134 should be used to describe the revision of both the femoral and acetabular components. There is not a specified minimum time interval between the initial arthroplasty and the revision, but it must be at a separate session. Since code 27134 includes the removal of existing hardware and insertion of new total hip hardware or its components, it would not be appropriate to report code 27091, Removal of hip prosthesis; (separate procedure), in addition to code 21734.

27132 Conversion of previous hip surgery to total hip arthroplasty, with or without autograft or allograft

27125 Hemiarthroplasty, hip, partial (eg, femoral stem prosthesis, bipolar arthroplasty)

27134 Revision of total hip arthroplasty; both components, with or without autograft or allograft
27137 acetabular component only, with or without autograft or allograft
27138 femoral component only, with or without allograft

27130 Arthroplasty, acetabular and proximal femoral prosthetic replacement (total hip arthroplasty), with or without autograft or allograft

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Shoulder arthroplasty CPT codes

Shoulder arthroplasty includes cpt codes 23470, 23472-23474. This procedure is done to treat degenerative and inflammatory arthritis. In hemiarthroplasty of the shoulder, the head of the humerus bone is replaced. In total arthroplasty, both the head of the humerus and the glenoid are replaced.

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