Billing code 27091: Hip prosthesis removalMedicare rate & RVUs in Oregon
Reports difficult removal of all or part of an implanted hip prosthesis when extraction requires the complicated operative work distinguished from routine explantation.
CMS doesn’t publish an office rate for 27091 in Oregon.
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 27091 covers
An orthopedic surgeon uses this service to remove some or all of an implanted hip prosthesis when extraction involves complicated operative work. It may be performed for an infected or failed hip replacement, including situations where components are firmly fixed or removal requires extensive exposure. The operation is typically performed in a hospital operating room; the diagnosis alone does not establish that the removal was complicated.
Select this code when the operative report supports complicated extraction, and distinguish it from routine prosthesis removal and from revision surgery that replaces components. Document which components were removed and the operative circumstances that made extraction complex. This is major surgery with a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. In a same-session multiple-procedure claim, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, while 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 27091 pays more and less in Oregon
| Payment locality | Office | Facility |
|---|---|---|
| Portland | Unavailable | $1,459.79 |
| Rest Of Oregon | Unavailable | $1,385.44 |
How the 27091 rate is calculated
Each of 27091’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 · 27091
RVUs × geographic indexes × conversion factor
Work23.74
23.74 RVUs× 1.000 GPCI
Practice expense14.26
14.26 RVUs× 1.000 GPCI
Malpractice5.03
5.03 RVUs× 1.000 GPCI
Adjusted RVUs
43.0300
Conversion factor
$33.4009
Medicare rate
$1,437.24
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 27091
27091 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 27091
Hip prosthesis 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 · 27091
Hip prosthesis 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
27091 without 50 · national facility
$1,437.24
Hip prosthesis removal
27091-50 · Bilateral: 150%
$2,155.86
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).
27091 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 27090Hip implant removal
- Both concern removal of a hip prosthesis. Choose 27091 when the operative report supports complicated extraction; 27090 is the related code without that distinction.
- 27134Hip revision
- Use 27134 for revision of both hip components when replacement is performed. Code 27091 represents complicated removal rather than definitive revision arthroplasty.
- 27137Hip revision
- Code 27137 describes revision of the acetabular component. Code 27091 describes complicated prosthesis removal, not acetabular component revision.
- 27138Hip revision
- Code 27138 describes revision of the femoral component. Code 27091 describes complicated prosthesis removal rather than femoral component revision.
27091 billing questions
How does this differ from 27090?
Use 27091 when the operative documentation supports complicated prosthesis extraction. Code 27090 describes the related removal service without the complicated distinction.
Does an infected hip replacement automatically qualify?
No. Infection may be the reason for removal, but the operative report should describe the complicated extraction work; the diagnosis alone does not establish it.
Should 27091 be reported with a hip revision code?
When components are removed as part of a definitive revision arthroplasty, compare the applicable revision code, such as 27134 for revision of both components, rather than treating removal alone as the service.
How is a second procedure in the same session paid?
Under the standard multiple-procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50%.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team surgery is not permitted for this service.
What is the bilateral payment rule?
Bilateral reporting with modifier 50 is paid at 150% under the CMS facts for this code.
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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