Summary & Overview
CPT 27086: Removal of Foreign Body from Subcutaneous Pelvis or Hip
CPT code 27086 denotes surgical removal of a foreign body from the subcutaneous tissue of the pelvis or hip. This code captures a focused, minor operative procedure to extract non-native material located in the superficial soft tissues of the pelvic or hip region. It is relevant nationally because such procedures are commonly performed across outpatient and ambulatory surgical settings and have implications for coding accuracy, clinical documentation, and payer coverage decisions.
Key payers included in typical analyses are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context, typical sites of service, and the scope of the procedure. The publication also covers billing benchmarks and common modifier usage where applicable, core documentation elements required to support medical necessity, and potential policy updates that affect coverage and payment workflows. Where input data is not provided, the text notes that specific fields are unavailable.
This summary is intended for coding professionals, billing managers, and clinical leaders seeking a clear, national-level briefing on CPT code 27086, its clinical application, and the operational considerations that influence reimbursement and compliance.
Billing Code Overview
CPT code 27086 describes the removal of a foreign body from the subcutaneous tissue of the pelvis or hip. The procedure involves incision and extraction of an extraneous object located in the subcutaneous layer in the pelvic or hip region.
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Service type: Surgical procedure, minor soft-tissue foreign body removal
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Typical site of service: Ambulatory surgery center, hospital outpatient department, or office-based procedure room depending on clinical complexity and facility resources
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Clinical & Coding Specifications
Clinical Context
A middle-aged patient presents to an outpatient clinic after stepping on debris that penetrated the soft tissues over the lateral hip. The patient reports localized pain, a small puncture wound, and inability to remove a suspected retained foreign body despite home attempts. Examination shows a superficial entry site with palpable subcutaneous material over the greater trochanter region without signs of deep joint involvement. Plain radiographs confirm a radiopaque foreign object within the subcutaneous tissue of the pelvis/hip region.
The clinical workflow includes triage and wound assessment, imaging to localize the foreign body (plain X-ray and, if needed, ultrasound or CT), informed consent, and preparation for minor procedure. The provider administers local anesthesia, performs aseptic prep, makes a small incision, dissects down to the subcutaneous plane, removes the foreign body, achieves hemostasis, and closes the wound with sutures or adhesive strips. Post-procedure care includes wound dressing, tetanus update if indicated, instruction on signs of infection, and documentation of the removed specimen. The encounter is billed using 27086 for removal of a foreign body from subcutaneous tissue of the pelvis or hip, typically performed in an ambulatory surgical center, emergency department, or office procedure room depending on complexity and setting.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
23 |