CPT 27130 · Other Procedure · Oscar Health
Total Hip Arthroplasty (THA) at Oscar Health.
How Oscar Health approaches CPT 27130 (Total Hip Arthroplasty (THA)) for prior-authorization review: at last review on 2025-09-01, the policy covers this code with prior authorization required.
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Coverage
Covered
Prior auth
Prior auth required
Last reviewed
2025-09-01
Policy number
CG070 v5Criteria summary
High-level themes from the Oscar Health 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: Oscar Clinical Guideline CG070: Total Hip Arthroplasty (Replacement)
See the full Oscar Health criteria.
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