2025 CPT code 27090
(Active) Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures on the Musculoskeletal System Musculoskeletal System Feed
Removal of hip prosthesis; (separate procedure)
Modifiers may be applicable depending on the circumstances of the procedure.Consult current CPT guidelines for modifier use, including 59 (distinct procedural service).
Removal of a hip prosthesis is medically necessary when the prosthesis is loose, fractured, infected, or causing significant pain and dysfunction not relieved by conservative measures.Documentation must support the clinical indication for removal and the need for the procedure.
The orthopedic surgeon is responsible for performing the removal of the hip prosthesis. This involves surgical expertise in hip anatomy, joint replacement techniques, and post-operative care.
In simple words: The doctor removes a damaged or loose artificial hip joint. This is done through a cut in the hip area, carefully working around nerves. The damaged part is taken out, the area is cleaned, and the cut is stitched up.Sometimes, a drain is used to help with healing.
This CPT code, 27090, represents the surgical removal of a hip joint prosthesis as a distinct procedure.The procedure involves an incision to access the hip joint, dissection through subcutaneous tissue, protection of the sciatic nerve, release of soft tissues, dislocation of the femoral prosthesis, potential sectioning of the femur to facilitate removal, wound irrigation, and layered closure.A drain may be placed post-operatively. This is typically part of a revision arthroplasty but can be a separate procedure if performed in a different anatomical location or with an unrelated procedure.
Example 1: A patient presents with a loosening of their previously implanted hip prosthesis.The surgeon performs a revision arthroplasty, which includes removal of the old prosthesis (27090) and implantation of a new one (27138)., A patient experiences infection at the site of their hip prosthesis. The surgeon removes the infected prosthesis (27090), performs debridement and antibiotic treatment, and plans for re-implantation at a later date., A patient has a fracture of the femur near the hip prosthesis. The surgeon addresses the fracture and, during the same procedure, removes the loose prosthesis (27090) to facilitate fracture repair and to prevent prosthesis-related complications.
* Pre-operative imaging (x-rays, CT scans) to assess prosthesis condition and surrounding bone.* Operative report detailing the steps of the procedure, including the type of prosthesis removed and any complications encountered.* Post-operative imaging to assess the success of the removal and any residual issues.* Pathology report if tissue samples were collected.* Medical necessity documentation showing why the prosthesis removal was clinically necessary.
** This code should only be reported when the removal of the hip prosthesis is performed as a distinct and separate procedure from other services.Refer to the most recent CPT manual for detailed information and any updates to coding guidelines.
- Revenue Code: P3D (MAJOR PROCEDURE, ORTHOPEDIC - OTHER)
- RVU: Information not available in provided text.Consult the most current RVU data for accurate values.
- Global Days : Information not available in provided text. Consult current CPT guidelines for the global period associated with this code.
- Payment Status: Active
- Modifier TC rule: The TC modifier is not typically applied to 27090 as it represents the entire procedure.However, always refer to your specific payer's guidelines.
- Fee Schedule : Information not available in provided text. Consult historical CPT fee schedules or payer-specific data for historical fee information.
- Specialties:Orthopedic Surgery
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center