Does 27005 require prior authorization?

No, 27005 does not require prior authorization (high confidence). Code is covered without prior authorization.

What is the Medicare reimbursement rate for 27005?

Medicare facility rate: $674.03. Non-facility rate: $674.03. Work RVU: 9.82.

HCPCS/CPT

No Prior Auth Required

Code is covered without prior authorization (high confidence)

Work RVU

9.82

Facility

$674.03

Non-Facility

$674.03

Use of intra-operative/intra-wound vancomycin powder: document dosing/administration, indication, baseline infection risk factors, and post-operative monitoring for wound complications, AKI, ototoxicity (authors reported no statistical difference but monitored these endpoints).
When using TXA: documentation of procedure type (primary THA), route and dosing of TXA (intravenous, topical, or combined), and exclusion/consideration if revision THA or hip fracture surgery (VHA: evidence lacking in revisions/hip fracture).
Robotic or navigation-assisted THA: pre-operative target angles, intra-operative navigation records (intra-operative cup angles using navigation records), and post-operative imaging to verify cup orientation (post-operative CT data or radiographs) as used in the cited studies (e.g., HipAlign intra-op records vs post-op CT comparisons).

Progressive or substantial periprosthetic bone loss confirmed by imaging;
Outside-in arthroscopic psoas release for anterior iliopsoas impingement after primary total hip arthroplasty
Fracture or mechanical failure of 1 or more components of the prosthesis confirmed by imaging;
Confirmed periprosthetic infection confirmed by gram stain and culture;
Displaced periprosthetic fracture confirmed by imaging;
Bearing surface wear leading to symptomatic synovitis or local bone or soft tissue reaction;

AETNA-CPB-0287 — Hip Arthroplasty

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