CPT 27130 · Arthroplasty — Hip · Pennsylvania PIP / First-Party Medical
Total Hip Arthroplasty (THA) at Pennsylvania PIP / First-Party Medical.
How Pennsylvania PIP / First-Party Medical 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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PA-PIP-2026Criteria summary
High-level themes from the Pennsylvania PIP / First-Party Medical 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: PA Motor Vehicle Financial Responsibility Law — First-Party Medical Benefits
See the full Pennsylvania PIP / First-Party Medical criteria.
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