CPT 27130 · Arthroplasty — Hip · North Carolina Medicaid
Total Hip Arthroplasty (THA) at North Carolina Medicaid.
How North Carolina Medicaid approaches CPT 27130 (Total Hip Arthroplasty (THA)) for prior-authorization review: at last review on 2026-05-02, the policy covers this code with prior authorization required.
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NCMed-Surg-2026Criteria summary
High-level themes from the North Carolina Medicaid 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: NC Medicaid Clinical Coverage Policy — Outpatient Surgery
See the full North Carolina Medicaid criteria.
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