CPT 27130 · Other Procedure · Tricare
Total Hip Arthroplasty (THA) at Tricare.
How Tricare approaches CPT 27130 (Total Hip Arthroplasty (THA)) for prior-authorization review: at last review on 2024-09-25, the policy covers this code with prior authorization required.
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Verification pending. This record is awaiting confirmation against the latest policy document — criteria summary may not reflect the current revision.
Criteria summary
High-level themes from the Tricare 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: TRICARE Policy Manual 6010.63-M (TPT5), Chapter 4 Section 6.1 (Surgery — orthopedic procedures)
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