Lower Extremity Major Joint Replacement (Hip and Knee)
JH · Effective Oct 1, 2015
19 active Medicare policies list 27138, and 12 commercial payer policies list it. See each policy's status for the code and its official source. Listing a code is not a coverage decision: read each policy’s source for the requirements that apply.
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JH · Effective Oct 1, 2015
JL · Effective Oct 1, 2015
J9 · Effective Oct 1, 2015
JE · Effective Oct 1, 2015
JF · Effective Oct 1, 2015
J15 · Effective Mar 15, 2026
J6 · Effective Dec 1, 2015
JK · Effective Dec 1, 2015
JJ · Effective Oct 1, 2015
JM · Effective Oct 1, 2015
12 policies from 10 payers
Summary of the payer’s published policy. Not a coverage determination — confirm with the payer before submitting.
| Policy | Effective | Status of 27138 |
|---|---|---|
| Joint Surgery | Nov 15, 2025 | Covered |
| Joint Surgery [for Anthem BCBS Ohio Medicaid] | Nov 17, 2024 | Covered |
| Policy | Effective | Status of 27138 |
|---|---|---|
| Cigna Commercial Joint Surgery Code List | Mar 7, 2026 | Prior auth required |
| Cigna Comprehensive Code List | Mar 7, 2026 |
J5 · Effective Oct 13, 2024
J8 · Effective Oct 13, 2024
JL · Effective Jan 1, 2026
J9 · Effective Jun 25, 2026
National · Effective Nov 6, 2025
National · Effective Jan 1, 2026
J6 · Effective Apr 1, 2026
J5 · Effective Aug 27, 2026
National · Effective Mar 15, 2026
| Prior auth required |
| Policy | Effective | Status of 27138 |
|---|---|---|
| Cigna Commercial & Medicare Advantage Joint Surgery Code List | Jan 1, 2026 | Prior auth required |
| Policy | Effective | Status of 27138 |
|---|---|---|
| EOCCO Joint Surgery Code List | May 1, 2026 | Prior auth required |
| Policy | Effective | Status of 27138 |
|---|---|---|
| Hip Arthroplasty | Mar 16, 2026 | Covered |
| Policy | Effective | Status of 27138 |
|---|---|---|
| Surgery of the Hip – Surest Medical Policy | Sep 10, 2026 | Covered |
| Policy | Effective | Status of 27138 |
|---|---|---|
| The Health Plan MSK Joint Code List | Jan 1, 2026 | Prior auth required |
| Policy | Effective | Status of 27138 |
|---|---|---|
| Surgery of the Hip | Sep 10, 2026 | Covered |
| Policy | Effective | Status of 27138 |
|---|---|---|
| Surgery of the Hip | Sep 10, 2026 | Covered |
| Policy | Effective | Status of 27138 |
|---|---|---|
| Joint Procedures | Not recorded | Covered |