CPT code 27591: Thigh amputation, primary closure2026 Medicare rate & RVUs

Medicare pays $889.13 for 27591 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 27591 covers

This service removes the lower limb through the femur and includes primary closure of the operative site. It may be performed by an orthopedic, vascular, or general surgeon, often in a hospital operating room for conditions such as advanced limb ischemia with gangrene, an unsalvageable traumatic injury, or extensive infection. The amputation level is through the thigh; a below-knee procedure is a different service.

Select this code when the operative documentation supports a thigh amputation with primary closure. The note should identify the level and side, the reason for amputation, and how the wound was managed. Medicare 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 is paid in full and others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery services may be paid; co-surgeons are paid only with 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 27591 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

27591 rates by state

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

How the 27591 rate is calculated

Each of 27591’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 27591

27591 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

27591 compared with similar codes

How to choose

27590Thigh amputationThrough femur, any level

Both describe thigh-level amputation, but 27591 specifies primary closure. Choose 27590 when that closure distinction is not documented.

27592Thigh amputationImmediate prosthesis fitting

Choose 27592 when immediate prosthesis fitting is part of the service; primary closure without that distinction points to 27591.

27594Amputation revisionThigh-level stump

27594 describes revision of an existing thigh amputation. Code 27591 is for the amputation itself with primary closure.

27880Leg amputationThrough tibia and fibula

27880 is an amputation through the tibia and fibula. Code 27591 is for an amputation through the femur.

Codes related to 27591

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