CPT 27702 · Arthroplasty — Ankle
Total Ankle Arthroplasty
Total Ankle Arthroplasty (27702) — payor coverage and prior-authorization requirements across all Medicare MACs, commercial payors, BCBS plans, and Medicaid programs tracked by Rubrica.
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Rubrica tracks payor coverage for CPT 27702 (Total Ankle Arthroplasty) across 23 payors — every Medicare MAC, the major commercial plans, the BCBS family, all 50-state Medicaid programs, and selected workers' comp and auto/PIP carriers. Aggregate coverage patterns are shown below; full payor-specific criteria, source citations, and last-reviewed dates are available to signed-in practitioners.
Top payors covering CPT 27702
Sample of 12 payors with coverage for this code. Sign in for the complete payor list, verbatim criteria, denial-risk score, and source citations for each.
| Payor | Coverage | Prior auth |
|---|---|---|
| Aetna | Covered | Prior auth |
| Aetna Medicare Advantage | Covered | Prior auth |
| Anthem BCBS | Covered | Prior auth |
| BCBS Illinois | Covered | Prior auth |
| BCBS Michigan | Covered | Prior auth |
| BCBS Texas | Covered | Prior auth |
| Cigna | Covered | Prior auth |
| Cigna Medicare / HealthSpring | Covered | Prior auth |
| Florida Blue | Covered | Prior auth |
| Highmark BCBS | Covered | Prior auth |
| Humana | Covered | Prior auth |
| Humana Medicare Advantage | Covered | Prior auth |
Coverage themes for CPT 27702
Common patterns across the 23 payors we track. Specific criteria per payor are available after sign-in.
Most payors require ≥12 weeks of conservative care before approving 27702.
20 of 23 payors require imaging concordance documentation.
Of the 23 payors with coverage records for CPT 27702, 13 require prior authorization, 10 cover without prior authorization, and 0 flag the procedure as investigational or experimental under current criteria.
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Sign in to see verbatim coverage criteria, conservative-care duration requirements, imaging concordance rules, and the documentation each payor wants in the submission.
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