2025 CPT code 27488

Removal of knee prosthesis, including total knee prosthesis, methylmethacrylate with or without spacer insertion.

Follow current CPT guidelines for surgical procedures of the knee joint.Modifiers may be necessary based on the specifics of the case.

Modifiers may apply depending on circumstances; consult the CPT manual for appropriate modifier use. For example, modifier 54 (surgical care only) may be used if the initial treating physician is not providing subsequent treatment.

Medical necessity is established by the presence of a loose or infected prosthesis, instability, persistent pain despite conservative treatment, or significant functional impairment due to the prosthetic joint.

The orthopedic surgeon is responsible for the surgical removal of the prosthesis, meticulous removal of cement, assessment of bone and soft tissue, and decision regarding spacer insertion. Post-operative care, including pain management and wound care, is also the responsibility of the surgeon.

In simple words: The doctor surgically removes a damaged or loose artificial knee joint (prosthesis) and the bone cement holding it in place.They may or may not put a temporary spacer in the knee joint to maintain its shape until a new joint is put in later.

This procedure involves the surgical removal of a total knee prosthesis.The procedure includes breaking the methylmethacrylate bone cement and removing the prosthesis from the tibia and/or femur.Removal of the cement from the implant border is also included.A spacer may be inserted into the joint space after prosthesis removal to prevent limb shortening, this spacer would be removed in a subsequent procedure when a new prosthesis is implanted. The wound is irrigated with an antibiotic solution and closed in layers. A drain may be left in place if necessary.

Example 1: A 70-year-old female patient presents with a loosening total knee arthroplasty. The prosthesis is removed, cement removed, and a spacer placed.A new prosthesis will be implanted in a later surgery., A 65-year-old male patient experiences deep infection at the site of his total knee arthroplasty. The infected prosthesis is removed, the joint is thoroughly debrided, and an antibiotic-impregnated spacer is placed. The spacer will remain until infection is cleared, after which a new prosthesis will be implanted., A 55-year-old patient with a history of trauma to their previously implanted knee prosthesis needs the prosthesis removed. There is a fracture of the femur. Prosthesis removal and fracture repair are performed simultaneously.

* Preoperative diagnosis and indication for removal.* Operative report detailing the type of prosthesis removed, the condition of the bone and soft tissues, and the technique used for removal and spacer insertion (if applicable).* Pathology report (if applicable).* Postoperative progress notes documenting the patient's recovery.* Imaging studies (X-rays, CT scans) pre- and post-operatively.

** This code is used for the removal of a total knee arthroplasty only.If another prosthesis is removed, another code may apply. If a new prosthesis is inserted during the same surgical encounter, that procedure should be coded separately.

  • Revenue Code: P3D (MAJOR PROCEDURE, ORTHOPEDIC - OTHER)
  • Payment Status: Active
  • Modifier TC rule: Not applicable.
  • Specialties:Orthopedic Surgery
  • Place of Service:Inpatient Hospital, Ambulatory Surgical Center
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