CPT 27130 · Arthroplasty — Hip · BCBS Illinois
Total Hip Arthroplasty (THA) at BCBS Illinois.
How BCBS Illinois approaches CPT 27130 (Total Hip Arthroplasty (THA)) for prior-authorization review: at last review on 2026-04-15, the policy covers this code with prior authorization required.
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BCBSIL-Ortho-2026Criteria summary
High-level themes from the BCBS Illinois policy of record for CPT 27130. 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: BCBS Illinois Medical Policy / Carelon Clinical Appropriateness Guidelines — Orthopedic Surgery
See the full BCBS Illinois criteria.
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