CPT code 27590: Thigh amputation, through femur, any level2026 Medicare rate & RVUs

Medicare pays $721.13 for 27590 nationally in a facility.

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 27590 covers

The surgeon removes the lower limb through the femur, with the level selected according to the extent of disease or injury and the tissue available for a residual limb. Typical cases include a limb rendered nonviable by advanced ischemia, extensive infection, major trauma, or a tumor requiring removal. These operations are generally performed in a hospital operating room by an orthopedic, vascular, or general surgeon, depending on the underlying condition.

Choose the code that matches the operative technique and closure: this code is distinct from the related thigh-amputation codes for primary closure or an open circular procedure. The operative report should identify the femoral level, indication, and closure approach. 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 the same session, the highest-valued procedure is paid in full and others at 50%. For bilateral procedures reported with modifier 50, CMS pays at 150%. An assistant at surgery may be paid; 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 27590 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

27590 rates by state

Office rate range in each state. Select a state to see its payment localities.

How the 27590 rate is calculated

Each of 27590’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.

Payment rules and modifiers for 27590

27590 has a 90-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 50

27590 compared with similar codes

How to choose

27591Thigh amputationPrimary closure

This code is for a thigh amputation with primary closure. Select it when primary closure is documented rather than reporting 27590.

27592Thigh amputationImmediate prosthesis fitting

This code describes an open, circular thigh amputation. The operative technique, not just the indication for amputation, distinguishes it from 27590.

27594Amputation revisionThigh-level stump

This code is for re-amputation through the femur. Use 27590 for the initial thigh amputation, not a subsequent re-amputation.

27598Leg amputationThrough knee joint

This code describes amputation at the knee joint through the tibia and fibula. Code 27590 is for amputation through the femur.

Codes related to 27590

Related codes aren’t interchangeable: bill the code that matches the service performed.

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

Open CMS sourceHow we calculate rates