Arthroplasty is a surgical procedure in which the articular surfaces of a joint are reconstructed, resurfaced, or replaced — either with a prosthetic implant (replacement arthroplasty) or by reshaping and interposing biological or synthetic material (interpositional arthroplasty) — with the goals of eliminating pain, restoring joint biomechanics, and improving functional mobility. It is distinguished from arthrodesis, in which the joint is surgically fused to eliminate motion entirely, and from arthroscopy, which is a minimally invasive diagnostic and therapeutic technique that does not involve joint reconstruction or implantation. The underlying mechanism involves removal of damaged cartilage and subchondral bone, preparation of the bony surfaces, and fixation of prosthetic components using cement, press-fit, or hybrid techniques, depending on implant design and patient bone quality. Arthroplasty may be physiologically indicated as an elective procedure for end-stage degenerative joint disease (e.g., osteoarthritis M16.x, M17.x) or as an urgent/emergent procedure following traumatic joint destruction or femoral neck fracture (S72.0x); pathological indications include rheumatoid arthritis (M05.x, M06.x), avascular necrosis (M87.x), and post-septic joint deformity. The most coding-relevant subtypes are total hip arthroplasty (THA; CPT 27130), total knee arthroplasty (TKA; CPT 27447), total shoulder arthroplasty (CPT 23472), and partial/hemi-arthroplasty procedures (CPT 27125, 23470). It is most commonly confused with arthroscopy — which involves no implant — and with arthrodesis — which sacrifices motion rather than restoring it; both distinctions are critical for correct CPT code assignment and DRG grouping.
Greek plassein (PLAS-ein), noun form plastia (PLAS-tee-ah)
Noun-forming suffix — “molding,” “shaping,” “surgical repair or reconstruction of” — denotes a surgical procedure that reshapes, reconstructs, or replaces a structure
The word entered English in the 1840s as arthroplasty (noun), formed directly from New Latin and Greek elements via surgical nomenclature — literally “surgical shaping of a joint.” The adjective form arthroplastic emerged shortly thereafter in surgical literature. The root arthron (“joint”) connects arthroplasty to the entire arthr- root family: arthritis (arthr- + -itis → inflammation of a joint), arthroscopy (arthr- + -scopy → visual examination of a joint), and arthrodesis (arthr- + -desis → surgical binding/fusion of a joint). The surgical suffix-plasty is one of the most productive suffixes in operative terminology: rhinoplasty, mammoplasty, palatoplasty, tympanoplasty, urethroplasty.
🔀 ALIASES / ALTERNATE TERMS
Arthroplastic(adjective form — used in collocations such as “arthroplastic reconstruction,” “arthroplastic component,” “arthroplastic revision”)
Joint replacement surgery(lay synonym — the term used in patient education materials, consent forms, and lay press; functionally equivalent to total arthroplasty in most contexts)
Total joint arthroplasty (TJA)(clinical synonym for procedures replacing both articular surfaces of a joint — hip, knee, shoulder, ankle; distinguished from hemi or partial arthroplasty)
Prosthetic joint replacement(clinical descriptor emphasizing implant use; coded with Z96.6x-Z96.69x for status post hip/knee replacement on subsequent encounters)
Hemiarthroplasty | Partial arthroplasty(replacement of only one articular surface — typically the femoral head [hip] or humeral head [shoulder]; CPT 27125 for hip, CPT 23470 for shoulder; M87.x and S72.0x are common indications)
Resurfacing arthroplasty(bone-conserving alternative to total arthroplasty in which only the articular surface is capped rather than the entire femoral head removed; CPT 27299 [unlisted] or 27130 depending on payer; common in younger, active patients)
Revision arthroplasty(surgical removal and replacement of a failed or infected prosthesis; CPT 27134, 27137, 27138 for hip; 27486, 27487 for knee; T84.0X1A-T84.099A for mechanical complication coding)
Interpositional arthroplasty(biological or synthetic material interposed between joint surfaces without a formal implant; used in CMC thumb arthroplasty — CPT 25447; and temporomandibular joint — CPT 21240)
Total hip arthroplasty (THA)(replacement of both femoral head and acetabulum with prosthetic components; CPT 27130; primary indication M16.x [hip OA] and M87.05x [AVN])
Total knee arthroplasty (TKA)(replacement of distal femoral, proximal tibial, and patellar surfaces; CPT 27447; primary indication M17.x [knee OA]; one of the highest-volume inpatient procedures by DRG 469/470)
Total shoulder arthroplasty (TSA)(replacement of humeral head and glenoid; CPT 23472; indication M19.011-M19.019 [primary OA of shoulder]; distinguished from reverse TSA — CPT 23472 — used for rotator cuff tear arthropathy)
Unicompartmental knee arthroplasty (UKA)(partial knee replacement limited to one compartment — medial or lateral; CPT 27446; indication M17.31-M17.32 [post-traumatic OA] or medial compartment OA)
🔗 RELATED TERMS
arthrodesis — the opposite surgical goal of arthroplasty; joint surfaces are fused together to eliminate motion entirely, sacrificing mobility for stability and pain relief — coded by joint site (e.g., M43.27 for spinal fusion; CPT 27580 for ankle arthrodesis)
Arthroscopy — shares the arthr- root; minimally invasive joint visualization and intervention using a fiber-optic scope — does not involve implantation or joint reconstruction; CPT 29800-29999 series
Arthritis — shares the arthr- root; the primary disease process driving the indication for arthroplasty; end-stage osteoarthritis (M16.x, M17.x) and rheumatoid arthritis (M05.x) are the most common indications
osteoarthritis — the leading indication for elective total joint arthroplasty; characterized by progressive cartilage loss, subchondral sclerosis, and osteophyte formation — coded by joint and laterality (M16.x hip; M17.x knee; M19.x other joints)
Avascular Necrosis — osteonecrosis of the femoral or humeral head due to impaired blood supply; a major indication for hemiarthroplasty or THA/TSA (M87.05x hip; M87.021-M87.022 humeral head)
Prosthesis — the implanted mechanical device that replaces the articular surface; complications of joint prostheses are coded to T84.0X1A-T84.099A (mechanical) or T84.50XA-T84.59XA (infection)
Synovectomy — surgical removal of the inflamed synovial membrane; may be performed as a standalone procedure (CPT 27054 knee) or as a component of arthroplasty in inflammatory arthritis
Periprosthetic joint infection (PJI) — deep infection of a joint prosthesis requiring irrigation and debridement (CPT 27303) or two-stage revision arthroplasty; coded T84.50XA (infection of prosthetic joint) + organism code
Periprosthetic fracture — fracture occurring around an existing joint prosthesis; coded M97.01XA-M97.9XXA depending on joint; treated with ORIF (CPT 27236, 27248) or revision arthroplasty
osteotomy — surgical cutting and realignment of bone to correct deformity or shift joint loading; used as a joint-preserving alternative to arthroplasty in younger patients (CPT 27140 hip; 27455-27457 knee)
Heterotopic Ossification — pathological bone formation in periarticular soft tissue following arthroplasty (M61.10-M61.19); a known complication documented post-THA and post-TKA; may require surgical excision (CPT 27006)
Rheumatoid Arthritis — systemic autoimmune arthritis (M05.x, M06.x) causing symmetric joint destruction; a primary inflammatory indication for arthroplasty when medical management fails
Radiograph of joint (plain film) — primary preoperative and postoperative imaging for arthroplasty evaluation; CPT 73502-73503 (hip), 73562-73564 (knee), 73030 (shoulder); used to assess component alignment, loosening, and osteolysis
CODING CORNER
🏥 ICD-10-CM CODES
Hip Arthroplasty Indications | Primary Osteoarthritis & AVN (Laterality Required)
Code
Description
M16.11
Primary osteoarthritis, right hip
M16.12
Primary osteoarthritis, left hip
M16.31
Dysplastic osteoarthritis, right hip
M16.32
Dysplastic osteoarthritis, left hip
M16.51
Post-traumatic osteoarthritis, right hip
M16.52
Post-traumatic osteoarthritis, left hip
M87.051
Osteonecrosis due to drugs, right femur
M87.052
Osteonecrosis due to drugs, left femur
M87.061
Osteonecrosis due to drugs, right tibia
M87.062
Osteonecrosis due to drugs, left tibia
Knee Arthroplasty Indications | Primary & Post-Traumatic OA (Laterality Required)
Periprosthetic fracture around internal prosthetic right hip joint, initial encounter
M97.02XA
Periprosthetic fracture around internal prosthetic left hip joint, initial encounter
M97.11XA
Periprosthetic fracture around internal prosthetic right knee joint, initial encounter
M97.12XA
Periprosthetic fracture around internal prosthetic left knee joint, initial encounter
🔧 COMMON CPT CODES (Arthroplasty-Related Procedures)
CPT Code
Description
27130
Total hip arthroplasty — primary THA; replacement of femoral head and acetabulum with prosthetic components
27125
Hemiarthroplasty, hip — replacement of femoral head only; used for femoral neck fractures and AVN without acetabular involvement
27134
Revision of total hip arthroplasty — both components; acetabular and femoral component revision
27447
Total knee arthroplasty — primary TKA; replacement of femoral, tibial, and patellar components
27446
Arthroplasty, knee, condyle and plateau; medial or lateral compartment — unicompartmental (partial) knee replacement
27486
Revision of total knee arthroplasty, with or without allograft; one component — partial revision
27487
Revision of total knee arthroplasty, with or without allograft; femoral and entire tibial component — full revision
23472
Arthroplasty, glenohumeral joint; total shoulder replacement — includes reverse total shoulder arthroplasty (rTSA)
23470
Arthroplasty, glenohumeral joint; hemiarthroplasty — humeral head replacement only
25447
Arthroplasty, interposition, intercarpal or carpometacarpal joints — thumb CMC arthroplasty with or without tendon interposition
27299
Unlisted procedure, pelvis or hip joint — used for hip resurfacing arthroplasty when payer does not recognize a specific code
⚠️ Coding Note:ICD-10-CM codes for arthroplasty indications (M16.x, M17.x, M19.x) require laterality at the highest level of specificity — never assign the unspecified laterality code when the operative report clearly documents right or left; this is one of the most common specificity failures on inpatient profee claims and can result in claim rejection or audit findings. For sequencing, the indication diagnosis (e.g., M16.11 primary OA right hip) is the principal diagnosis when the arthroplasty is the reason for the inpatient admission; the Z96.6x prosthetic joint status codes are never sequenced as principal diagnosis — they are always additional codes on subsequent encounters. Watch for the documentation trigger “failed prosthesis,” “loosening,” or “instability of prior joint replacement” — these should prompt assignment of the appropriate T84.0x complication code rather than the original indication code, and may support a CDI query to confirm whether the complication is mechanical or infectious, as this distinction drives DRG assignment between DRG 466-468 (revision hip/knee) vs. DRG 469-470 (primary hip/knee). For Medicare and Medicare Advantage plans, THA and TKA are no longer on the Inpatient Only list as of 2020 — confirm site-of-service appropriateness and document medical necessity for inpatient level of care. Modifier -22 (increased procedural services) may be applicable for revision arthroplasty with significant additional complexity such as bone grafting, structural allograft, or extended operative time exceeding the norm — ensure operative report documentation supports the modifier before appending.
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