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2025 CPT code 27138

Revision of total hip arthroplasty, femoral component only, with or without allograft.

The choice between codes 27130, 27132, 27134, 27137 and 27138 depends on which component of the hip is being revised (acetabular, femoral, or both). Separate codes should be used for removal of the old prosthesis if it is unusually difficult.

Modifiers may be applicable to 27138. For instance, modifier 54 (Surgical care only) may be used if the surgeon only performed the surgical portion of the procedure. 77 if the procedure is performed again by a different physician. 79 if different procedure is done after postoperative period by same physician.

Medical necessity for 27138 is established when the existing hip prosthesis is causing significant pain, instability, or dysfunction due to loosening, wear, fracture, infection, or other complications. Documentation should clearly support the patient's symptoms and the failure of conservative treatment options.

The surgeon makes an incision, removes the old femoral component of the hip implant, prepares the thigh bone, and implants the new femoral component. They secure the new component with bone cement, and close the incision.

In simple words: This surgery replaces the part of the artificial hip joint that fits into the thigh bone. The ball of the hip joint and/or the part that connects to the pelvis are not replaced in this procedure. Sometimes, donor bone tissue may be used to help rebuild the bone.

This procedure involves the surgical replacement of the femoral component of a total hip arthroplasty. It may or may not include the use of an allograft (bone graft from a donor). The procedure addresses issues with the existing femoral implant, such as loosening, wear, or fracture.

Example 1: A patient with a painful, loose femoral component of their hip replacement undergoes revision surgery to replace the femoral component with a new one., A patient experiences a fracture of their femoral stem and requires revision surgery to remove the broken stem and replace it with a new prosthesis and allograft., A patient with recurrent hip dislocation due to component malpositioning requires revision of the femoral component to improve stability.

Operative report detailing the procedure, including the type of prosthesis used, any allograft used, and any complications encountered. Preoperative imaging studies (X-rays, CT scans, or MRI) showing the condition of the hip joint and the need for revision.

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