Summary & Overview
CPT 27488: Removal of Total Knee Prosthesis, With or Without Spacer
Headline: CPT 27488 — Removal of Total Knee Prosthesis, Often with Spacer
Lead: CPT 27488 defines the surgical removal of a total knee prosthesis, frequently performed when implants fail, become infected, or require staged revision. It is an inpatient orthopedic procedure with implications for hospital resource use, perioperative care, and postoperative rehabilitation.
What this code represents and why it matters: CPT 27488 captures explantation of a knee prosthesis and possible insertion of a spacer, a key step in managing prosthetic joint infection and complex revisions. Nationally, this code affects hospital surgical caseloads, length of stay considerations, and bundled payment models tied to joint arthroplasty episodes.
Key payers covered: The analysis covers major national payers including Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
What readers will learn: The publication provides a concise clinical and billing overview of CPT 27488, compares related knee arthroplasty and revision codes, outlines typical inpatient utilization patterns, and explains common clinical contexts for explantation. It highlights relevant coding relationships for charting and claims submission and notes where input data is unavailable.
Additional notes: Service-line metadata was not provided. Data not available in the input where applicable.
CPT Code Overview
CPT 27488 describes the surgical removal of a knee prosthesis, including removal of a total knee prosthesis with methylmethacrylate, and may include insertion of a spacer. This procedure falls under Orthopedic Surgery and addresses situations requiring explantation of a knee implant, such as infection, mechanical failure, or preparation for staged revision.
The typical site of service for CPT 27488 is Inpatient Hospital (POS 21), where perioperative management and postoperative monitoring are provided in a hospital setting.
Clinical & Coding Specifications
Clinical Context
A 68-year-old patient with a previously implanted total knee prosthesis presents to the inpatient orthopedic service with escalating knee pain and evidence of prosthetic failure. Imaging and clinical exam suggest loosening and mechanical complication of the implant with associated pain. The patient is admitted to the hospital (POS 21) for operative management. The surgical plan includes removal of the existing total knee prosthesis, including removal of methylmethacrylate cement, with or without placement of an antibiotic spacer depending on intraoperative findings and infection risk. The workflow includes preoperative evaluation by an orthopaedic or adult reconstructive orthopaedic surgeon, perioperative anesthesia, intraoperative prosthesis and cement removal, possible spacer insertion, postoperative inpatient monitoring, and coordination with infectious disease if infection is suspected.
Coding Specifications
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Common Modifiers
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51- Multiple Procedures: Use when multiple distinct surgical procedures are performed at the same operative session by the same provider; appended per payer rules where applicable. -
59- Distinct Procedural Service: Use when a procedure is distinct or independent from other services performed on the same day; applies when documentation supports a separate procedural service. -
Provider Taxonomies