Summary & Overview
CPT 27295: Removal of Lower Extremity Through Hip Joint
CPT code 27295 denotes surgical removal of the entire lower extremity through the hip joint (hip disarticulation). As one of the most extensive lower-limb amputations, this procedure represents critical, often limb- or life-saving care and has substantial implications for hospital resource use, postoperative rehabilitation, prosthetic planning, and payer reimbursement pathways nationally. Key payers typically involved in coverage for this service include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
This publication provides a concise clinical and billing overview of CPT code 27295, offering readers: national context on why the procedure matters for acute care and rehabilitation capacity; benchmarks and coding considerations where available; and the clinical setting and service line implications for inpatient surgical and postoperative management. It also summarizes typical sites of service and the major clinical indications that commonly lead to this operation. Data not available in the input for items such as detailed payer-specific reimbursement rates, associated taxonomies, and ICD-10 diagnosis mappings are noted as not provided. The content is intended for clinicians, coding professionals, and payer policy analysts seeking a clear, national-level briefing on the clinical meaning and care setting for CPT code 27295.
Billing Code Overview
CPT code 27295 describes a surgical procedure in which the provider performs removal of the entire lower extremity through the hip joint (hip disarticulation or hemipelvectomy at the hip joint). This procedure is a major operative intervention addressing severe trauma, malignancy, infection, or nonviable limb conditions.
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Service type: Major surgical amputation of the lower extremity through the hip joint
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Typical site of service: Inpatient hospital operating room with subsequent inpatient postoperative care
Clinical & Coding Specifications
Clinical Context
A typical patient is a 68-year-old male with a chronically nonfunctional, pain-producing hip and extensive soft tissue and vascular compromise from advanced peripheral arterial disease, severe infection (e.g., osteomyelitis) or a malignant tumor involving the proximal femur and acetabulum. After multidisciplinary evaluation (vascular surgery, infectious disease, oncology, anesthesia, and rehabilitation medicine), the patient is scheduled for a surgical hip disarticulation (CPT 27295) when limb salvage is not feasible. Preoperative workflow includes optimization of cardiopulmonary status, vascular imaging, infectious workup with cultures and antibiotics as indicated, and prosthetic/rehabilitation planning.
On the day of service the patient undergoes general anesthesia. The orthopedic or vascular surgeon performs removal of the entire lower extremity through the hip joint, achieving hemostasis and appropriate soft-tissue management, and places drains as needed. Postoperative workflow includes intensive monitoring for hemorrhage, infection control, pain management (including regional techniques if appropriate), early mobilization with prosthetic/rehab team consultation, and discharge planning with home health or inpatient rehabilitation as needed.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
50 | Bilateral procedure | Use if bilateral hip disarticulations are performed (rare). |