CPT 27125 · Joint Arthroplasty · Medicare (Palmetto GBA MAC)
Hemiarthroplasty Hip (e.g., Femoral Neck Fracture) at Medicare (Palmetto GBA MAC).
How Medicare (Palmetto GBA MAC) approaches CPT 27125 (Hemiarthroplasty Hip (e.g., Femoral Neck Fracture)) for prior-authorization review: at last review on 2026-05-02, the policy covers this code with prior authorization required.
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Criteria summary
High-level themes from the Medicare (Palmetto GBA MAC) policy of record for CPT 27125. Verbatim policy text and per-criterion analysis are available after sign-in.
- At least 12 weeks of conservative care typically required.
- Imaging concordance documentation required.
Source: Medicare (Palmetto GBA MAC) LCD / Local Coverage Article
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