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    OpenPayerBilling CodesIncision Procedures on the Pelvis and Hip JointCPT cpt-26990-pelvis-hip-deep-abscess-drainage
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    CPT 26990: Incision and Drainage of Deep Pelvic or Hip Abscess

    Medicare pays $676 on average nationally for this procedure.

    CPT code 26990 describes the surgical incision and drainage of a deep abscess or hematoma in the pelvis or hip joint region, a procedural service typically performed in an operating room or procedure suite under appropriate anesthesia for definitive source control and evacuation of infectious or hemorrhagic collections.

    For related coverage guidance, see recent payer policy updates: Surgical Procedures, Outpatient Surgical Procedures - Site of Service, Site of Service Ambulatory Service Center (ASC) Select — Surgical or Diagnostic Procedures in Adults.

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    Clinical & Coding Specifications

    Clinical Context

    A typical patient is a 45-year-old male presenting to the emergency department with progressive left hip pain, fever, and limited range of motion after recent injection in the hip region. Imaging (ultrasound or CT) demonstrates a deep-seated fluid collection within the iliopsoas/hip region consistent with an abscess. The orthopedic or general surgery team evaluates the patient, confirms indication for operative drainage to control infection and relieve mass effect, and obtains informed consent. Preoperative steps include targeted laboratory studies (CBC, BMP, coagulation profile), blood cultures, and appropriate IV antibiotics. The procedure is performed in an operating room or procedural suite with appropriate anesthesia (general, regional, or monitored anesthesia care) and sterile preparation. The provider makes a deep incision, dissects to the abscess or hematoma in the pelvic/hip region, evacuates purulent material or clot, irrigates the cavity, places drains if indicated, and obtains specimens for Gram stain and culture. Postoperative care includes monitoring for hemodynamic stability, wound and drain management, continuation/adjustment of antibiotics based on culture results, and follow-up imaging or clinic visits to confirm resolution and wound healing. Typical sites of service: operating room, outpatient surgical center, or emergency operating suite.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    10180Incision and drainage, complex, postoperative wound infection (e.g., abscess)May be used for I&D of complex soft tissue infections when superficial and not involving deep pelvic/hip spaces; selected when anatomy differs from pelvic/hip joints
    20610Arthrocentesis, aspiration and/or injection of a major joint or bursa (e.g., hip)Performed preoperatively for diagnostic aspiration of hip joint fluid or therapeutic decompression under image guidance prior to definitive operative drainage
    27096Drainage or debridement procedures on the pelvis (deep) — note: there is no direct numeric match in CPT for pelvis drainage; use of pelvic debridement codes as clinically appropriateUsed when pelvic soft tissue debridement or drainage is required in addition to abscess evacuation (verify payer policy)
    10060Incision and drainage of abscess (simple or single)Used for more superficial, simple abscesses; not appropriate for deep pelvic/hip abscess but may be billed when scope is limited to superficial tissue
    49999Unlisted procedure, abdomen; generalOccasionally used when no specific CPT matches the exact pelvic/hip deep incision and drainage scenario; requires detailed operative report and payer preauthorization

    Related Modifiers

    9 rows

    ModifierDescriptionWhen to Use
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    66Modifier 66 (Surgical Team) is used when three or more surgeons act as primary surgeons on a single, highly complex procedure. The AMA defines it for use when a surgical team — often composed of…- Use modifier 66 when three or more surgeons act as primary surgeons working collaboratively as a surgical team on a single, highly complex or difficult procedure (for example organ…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
    79Modifier 79 indicates a surgical procedure performed during the postoperative global period of a prior surgery that is unrelated to the original procedure. Per AMA/CPT and CMS guidance, it is…- Use modifier 79 when the same physician (or same‑specialty physician in the same group) performs a surgical procedure during the postoperative global period of a prior surgery and the new procedure…
    50Modifier –50 (Bilateral Procedure) is appended to a CPT code when an identical procedure is performed on paired anatomical structures during the same operative session. The AMA states to add…- Use modifier -50 when the same CPT surgical, diagnostic, or radiology procedure is performed on paired anatomical structures (both sides of the body) during the same operative/session by the same…
    23Modifier -23 (Unusual Anesthesia) is used on anesthesia service CPT codes when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia…- Use modifier -23 only on anesthesia CPT codes (00100–01999) when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia because of…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    207X00000X
    207L00000X
    208000000X
    363LA2200X
    261QE0002X
    111NX0800X
    2472E0500X
    291U00000X

    Related Payer Policy Updates

    Specialty: General Surgery1 / 3

    10 rows

    PolicyPayerEffective Date
    Surgical ProceduresUnitedHealthcare2026-09-01
    Outpatient Surgical Procedures - Site of ServiceUnitedHealthcare2026-09-01
    Site of Service Ambulatory Service Center (ASC) Select — Surgical or Diagnostic Procedures in AdultsPremera Bluecross2026-09-01
    Site of Service Ambulatory Surgical Center (ASC) Select — Surgical or Diagnostic Procedures in AdultsPremera Bluecross2026-09-01
    Site of Service Ambulatory Service Center (ASC) SelectPremera Bluecross2026-09-01
    Site of Service Ambulatory Surgical Center (ASC) Select — Site of Service for Ambulatory Surgical Procedures (ASC Select)Premera Bluecross2026-09-01
    Site of Service Ambulatory Service Center (ASC) SelectPremera Bluecross2026-09-01
    Outpatient Surgical Procedures - Site of Servicesierra health and life2026-08-01
    Medical Necessity Guidelines — Inpatient Surgical CareMass General Brigham Health Plan2026-08-01
    Ambulatory Surgery Center (ASC) - Site of Care PolicyKaiser Permanente2026-08-01

    Related Codes

    CPT-26991-HIP-BURSA-INCISION-AND-DRAINAGE

    CPT 26991: Incision and Drainage of Hip or Pelvic Bursa

    CPT-26992-PELVIC-HIP-BONE-CORTEX-INCISION-FOR-INFECTION

    CPT 26992: Incision of Bone Cortex for Pelvis/Hip Infection

    CPT-27000-PERCUTANEOUS-ADDUCTOR-TENOTOMY-HIP

    CPT 27000: Percutaneous Tenotomy of Hip Adductor

    CPT-27001-HIP-ADDUCTOR-OPEN-TENOTOMY

    CPT 27001: Open Tenotomy of Hip Adductor

    CPT-27003-ADDUCTOR-TENOTOMY-OBTURATOR-NERVE-REMOVAL

    CPT 27003: Open Adductor Tenotomy with Obturator Nerve Removal

    CPT-27005-HIP-FLEXOR-OPEN-TENOTOMY

    CPT 27005: Open Tenotomy of Hip Flexor Tendon(s)

    CPT-27006-HIP-ABDUCTOR-EXTENSOR-OPEN-TENOTOMY

    CPT 27006: Open Tenotomy of Hip Abductor/Extensor Muscles

    CPT-27025-HIP-THIGH-FASCIOTOMY-DECOMPRESSION

    CPT 27025: Fasciotomy of Hip or Thigh

    CPT-27027-HIP-BUTTOCK-FASCIOTOMY-UNILATERAL

    CPT 27027: Fasciotomy, Pelvic/Buttock Compartment, Unilateral

    CPT-27030-HIP-JOINT-INCISION-EXPLORATION-DRAINAGE-INFECTION

    CPT 27030: Open Hip Arthrotomy with Drainage

    Showing 1–10 of 13

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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