Fees and Insurance

(Updated 5/22/2008)

VIII.CPT Codes

 
The American Medical Association publishes a set of codes that surgeons are required to use when billing for procedures. This is named “current procedural terminology”. These codes gradually change to reflect changes and advances in surgical techniques. The system often does not provide a code for the latest procedures. When we bill an insurance carrier,  they use these codes together with my fee to determine what they will pay on your behalf.  The most common codes that I employ are:

A. Standard total hip replacement                                                                    Total hip surface replacement

      27130       Arthroplasty, acetabular and proximal femoral prosthetic replacement.

B. Revision total hip replacement

27134, 27137, or 27138       Re-doing a hip replacement that has failed.

C. Partial Knee replacement

27446       Arthroplasty, knee, medial or lateral compartment

D. Total Knee replacement

27447       Arthroplasty,knee, medial and lateral compartment

E. Revision Knee replacement

27486,27487,27437,27438   Re-doing a knee replacement that has failed.

F. Knee arthroscopy 

29871 through 29881              The exact code depends on what is discovered at the time of surgery

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