Summary & Overview
CPT 27090: Removal of Hip Joint Prosthesis, Separate Procedure
CPT code 27090 denotes the surgical removal of a hip joint prosthesis performed as a separate procedure. This code is central to care pathways involving failed, infected, or otherwise problematic hip implants and has implications for surgical planning, hospital resource use, and postoperative care. Nationally, hip explantation procedures affect hospital quality metrics, surgical specialty workflows, and payer coverage determinations due to the complexity and potential need for staged reconstruction.
Key payers referenced in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context and typical sites of service, common modifier usage and billing considerations, payer coverage patterns and benchmarks where available, and relevant policy and coding guidance. The publication highlights procedural coding nuances, common scenarios that prompt use of the code (for example infection or mechanical failure), and operational considerations for surgical and facility billing teams. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 27090 describes a surgical procedure in which the provider removes a hip joint prosthesis as a separate procedure. This code covers the explantation or removal of a previously implanted hip joint prosthesis performed in the operative setting.
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Service type: Surgical procedure (orthopedic explantation)
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Typical site of service: Hospital operating room or ambulatory surgical center
Clinical & Coding Specifications
Clinical Context
A 72-year-old patient with a history of primary total hip arthroplasty presents with progressive pain, instability, and radiographic evidence of prosthetic loosening and peri-prosthetic osteolysis. The patient has chronic deep infection of the hip prosthesis confirmed by aspiration and positive cultures, and prior conservative treatment has failed. The orthopedic surgeon schedules a planned surgical removal of the hip joint prosthesis as a separate procedure to address infection and prepare for staged reimplantation.
Preoperative workflow includes history and physical, infectious disease consultation when infection is suspected, targeted laboratory testing (CBC, ESR, CRP), hip joint aspiration with culture and sensitivity, plain radiographs and CT as needed for component position and bone loss assessment, and medical optimization. On the day of service the patient undergoes removal of femoral and acetabular prosthetic components with possible debridement of infected tissue. If applicable, a temporary antibiotic spacer may be placed in the same operative setting or the procedure may be staged depending on surgical plan. Postoperative care includes targeted antibiotics, pain management, wound monitoring, and coordination for potential reimplantation and rehabilitation planning.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier — standard; use when no other modifier applies | Use for routine reporting when no special modifier is required |