CPT® 27235: Open Treatment of Closed Anterior Hip Dislocation Without Internal Fixation

CPT® 27235 — Open treatment of closed traumatic anterior hip dislocation, without internal fixation.

Code Details

Attribute	Value
CPT® Code	27235
Global Period	90 days
RVU (2024)	Work: 13.00 | PE: 12.45 | MP: 2.10 | Total: ~27.55
Modifier -51 Exempt?	No
Assistant at Surgery	Allowed (16% fee schedule)

Clinical Scenario

• Traumatic anterior dislocation (femoral head displaced anteriorly, often with femoral head/acetabular fracture).
• Closed reduction failed or contraindicated (interposed soft tissue, fracture block).
• Open reduction via anterior (Smith-Petersen) or anterolateral (Watson-Jones) approach.
• No internal fixation placed (if fixation added → use 27236).
• Capsular repair performed.

Documentation Requirements

• Operative note: approach, findings (labral tear, loose bodies, fracture fragments), reduction confirmation (fluoroscopy), capsular closure, neurovascular status.
• Indication for open vs. closed: failed closed reduction, incarcerated fragment, associated femoral head fracture requiring ORIF (then use 27236).

Related Codes

Code	Description
27230	Closed treatment of hip dislocation; without anesthesia
27232	Closed treatment of hip dislocation; requiring anesthesia
27236	Open treatment of hip dislocation, with internal fixation
27250	Closed treatment of hip dislocation, traumatic; without anesthesia (obsolete — use 27230)

Coding Tips

• Do not report 27235 with 27236 (mutually exclusive).
• If arthroscopic assistance used, append modifier -22 (increased procedural services) with documentation.
• Post-op care (90-day global) includes: E&M visits, cast/splint management, hardware removal (if any), uncomplicated follow-up.

Accurate coding captures the complexity of open hip reduction without fixation.