Billing code 27090: Hip implant removalMedicare rate & RVUs in Illinois
Reports operative removal of an implanted hip prosthesis when the service is removal rather than a complicated explant or component revision.
CMS doesn’t publish an office rate for 27090 in Illinois.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 27090 covers
An orthopedic surgeon removes an implanted hip prosthesis during an operative procedure, commonly to address periprosthetic infection, loosening, or implant failure when the planned service is removal rather than revision or replacement. The operation is generally performed in a hospital or other surgical facility. The surgeon’s report should identify the indication, the prosthetic components removed, and the extent and complexity of the explant; those details help distinguish this service from complicated removal or revision of one or more components.
Report 27090 when the operative work is the standard removal service, not as a separate charge for removal that is part of a component revision or replacement operation. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple procedure reduction. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
Where 27090 pays more and less in Illinois
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Chicago | Unavailable | $880.84 |
| East St. Louis | Unavailable | $829.17 |
| Rest Of Illinois | Unavailable | $790.98 |
| Suburban Chicago | Unavailable | $845.96 |
How the 27090 rate is calculated
Each of 27090’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 27090
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 11.40Practice expense 9.36Malpractice 2.39
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 27090
27090 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 27090
Hip implant removal
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.69/0.21 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 27090
Hip implant removal
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
27090 without 50 · national facility
$773.23
Hip implant removal
27090-50 · Bilateral: 150%
$1,159.85
Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).
27090 compared with similar codes
Compare codes
27090 vs 27091 vs 27134 vs 27137 vs 27138: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 27091Hip prosthesis removal
- Use 27090 for standard prosthesis removal; 27091 is the related code when the explant is documented as complicated.
- 27134Hip revision
- Use 27134 when both hip components are revised, rather than reporting removal alone with 27090.
- 27137Hip revision
- Use 27137 when the acetabular component is revised; 27090 describes removal of the prosthesis rather than that component revision.
- 27138Hip revision
- Use 27138 when the femoral component is revised; 27090 describes removal of the prosthesis rather than that component revision.
27090 billing questions
How is 27090 distinguished from 27091?
27090 describes standard removal of a hip prosthesis. Use 27091 when the operative documentation supports a complicated removal.
Can 27090 be separately reported with a hip revision?
When removal is part of a same-session component revision or replacement, report the code describing the revision or replacement work rather than separately adding 27090 for that removal.
What documentation supports 27090?
The operative report should state why the prosthesis was removed, identify the components removed, and describe the work and complexity of the explant.
How does the 90-day global period affect follow-up billing?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be available. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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