CPT® Code 27091

Removal of hip prosthesis; complicated, including total hip prosthesis, methylmethacrylate with or without insertion of spacer

The CPT® Code 27091 refers to the removal of a hip prosthesis in complicated cases, which may include a total hip prosthesis and the use of methylmethacrylate, with or without the insertion of a spacer. This procedure is typically indicated when there are complications associated with the existing hip prosthesis, such as infection or significant wear and tear. The surgical approach involves making an incision over the previous surgical site on the lateral aspect of the hip, allowing access to the prosthesis. Surgeons may encounter extensive scar tissue that necessitates careful dissection and release of surrounding soft tissues, including the psoas tendon and gluteus maximus insertion. The procedure requires dislocating the hip to expose the femoral head or the prosthetic component, followed by the meticulous removal of both the acetabular and femoral components. The removal process may involve excising the pseudocapsule and addressing any bone cement or bony overgrowth. In cases where the joint is infected, a spacer may be inserted to maintain joint space until a new prosthesis can be placed. This code is specifically designated for complicated removals, distinguishing it from simpler procedures, such as those coded under CPT® 27090.