Unlisted code for an open procedure on the pelvis or hip joint that no specific CPT code describes.
- Medicare
- $0.00
- Work RVU
- 0
- Global, days
- Region
- Hip
Documentation requirements
What must appear in the operative or office note to support the claim.
Source · Editorial brief grounded in 3 cited references ↓
- Operative note with approach, structures, and fixation
- Why no listed hip, pelvis, or Category III code applies
- Comparison code with time and risk reasoning
- Laterality
- Imaging and failed conservative care for elective cases
- Prior authorization
Applicable modifiers
Modifiers commonly billed with this code.
Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual
What this code covers
Source · Editorial summary grounded in 3 cited references ↓
27299 is the unlisted code for the pelvis and hip. Open or percutaneous procedures on the pelvic ring, acetabulum, proximal femur at the hip, and hip soft tissue use it when no listed code fits. Hip arthroscopy procedures without a specific code (labral reconstruction is a common example) go to 29999.
Coders used to send sacroiliac joint fusion here. Open and percutaneous SI joint arthrodesis now have listed codes, and billing 27299 when one of them fits is a fast denial. Check the current year's codes before filing anything involving the SI joint, and check Category III codes as well.
Medicare has no fee and a YYY global. Hip procedures that land here tend to be large cases, so the comparison code matters. Pick a listed hip or pelvis procedure with similar operative time and risk and explain the match. Prior authorization is standard for elective work.
RVU & reimbursement
Component RVUs and Medicare national rate. Actual payment varies by GPCI locality.
Source · CMS Physician Fee Schedule, RVU26A · January 2026
| Work RVU | 0 |
| Practice expense RVU | 0 |
| Malpractice RVU | 0 |
| Total RVU | 0 |
| Medicare national rate | $0.00 |
| Global period | days |
Payment by site of service
Medicare pays different rates by setting. HOPD typically pays substantially more than ASC for the same procedure.
Source · CMS OPPS Addendum B·ASC HCPCS payment rates·2026
| Setting | Medicare rate (national) |
|---|---|
Office (PFS non-facility) Procedure performed in physician's office | $0.00 |
HOPD (APC 5111) Hospital outpatient department | $252.01 |
Common denial reasons
The recurring reasons claims for CPT 27299 get rejected.
Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓
- SI joint fusion billed unlisted when a specific code exists
- Hip arthroscopy billed under open unlisted code
- Category III code exists
- No prior authorization
- Missing records with the claim
Frequently asked questions
Source · Generated from the editorial pipeline, verified against 3 cited references ↓
01Is SI joint fusion billed with 27299?
02What is the difference between 27299 and 29999 for the hip?
03How does Medicare pay CPT 27299?
Sources & references
Editorial content was developed using the following public sources.
Mira Scribe
Mira Scribe lays out approach, side, fixation, and the reason for surgery, which supports both prior authorization and payer pricing on an unlisted hip case.
See how Mira captures CPT 27299 documentation