CPT code 27591: Thigh amputation, primary closure2026 Medicare rate & RVUs in Connecticut
Reports a through-femur thigh amputation closed primarily, typically for severe limb ischemia, infection, trauma, or disease requiring removal of the limb.
In Connecticut, Medicare pays $944.65 for 27591 in a facility. There’s no office rate.
Check a contract rate as a % of Medicare · 27591 nationwide
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 11 sections
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.
How Connecticut compares for 27591
Across 109 of 109 payment localities, the facility rate for 27591 runs from $794.33 in Arkansas to $1,094.42 in Alaska. Connecticut pays $944.65. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Connecticut · this page$944.65
- Los Angeles, CA · California$936.94−$7.71
- Washington, DC area · District of Columbia$984.79+$40.14
- Miami, FL · Florida$1,051.60+$106.95
- Chicago, IL · Illinois$1,019.87+$75.22
- Manhattan, NY · New York$1,029.90+$85.25
- Alaska · Alaska$1,094.42+$149.77
Other areas in Connecticut first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | — | $804.70 |
| ArkansasArkansas | — | $794.33 |
| ArizonaArizona | — | $864.66 |
| Bakersfield, CACalifornia | — | $892.20 |
| Chico, CACalifornia | — | $884.20 |
| El Centro, CACalifornia | — | $884.68 |
| Fresno, CACalifornia | — | $884.20 |
| Hanford, CACalifornia | — | $884.20 |
| Madera, CACalifornia | — | $884.20 |
| Merced, CACalifornia | — | $884.20 |
| Modesto, CACalifornia | — | $884.20 |
| Napa, CACalifornia | — | $977.40 |
| Oxnard, CACalifornia | — | $926.72 |
| Redding, CACalifornia | — | $884.20 |
| Rest of CaliforniaCalifornia | — | $884.20 |
| Riverside, CACalifornia | — | $915.46 |
| Sacramento, CACalifornia | — | $915.47 |
| Salinas, CACalifornia | — | $911.85 |
| San Diego, CACalifornia | — | $924.48 |
| Marin County, CACalifornia | — | $1,018.26 |
| San Francisco, CACalifornia | — | $1,014.95 |
| San Benito County, CACalifornia | — | $1,043.37 |
| Santa Clara County, CACalifornia | — | $1,029.86 |
| San Luis Obispo, CACalifornia | — | $898.73 |
| Santa Cruz, CACalifornia | — | $926.24 |
| Santa Maria, CACalifornia | — | $912.85 |
| Santa Rosa, CACalifornia | — | $934.72 |
| Stockton, CACalifornia | — | $884.20 |
| Vallejo, CACalifornia | — | $972.63 |
| Visalia, CACalifornia | — | $884.20 |
| Yuba City, CACalifornia | — | $884.20 |
| ColoradoColorado | — | $894.93 |
| DelawareDelaware | — | $877.53 |
| Fort Lauderdale, FLFlorida | — | $972.06 |
| Rest of FloridaFlorida | — | $923.15 |
| Atlanta, GAGeorgia | — | $915.44 |
| Rest of GeorgiaGeorgia | — | $871.29 |
| Hawaii, Guam, HIHawaii | — | $894.52 |
| IowaIowa | — | $801.79 |
| IdahoIdaho | — | $810.87 |
| East St. Louis, ILIllinois | — | $960.65 |
| Rest of IllinoisIllinois | — | $914.45 |
| Suburban Chicago, ILIllinois | — | $976.47 |
| IndianaIndiana | — | $814.50 |
| KansasKansas | — | $808.47 |
| KentuckyKentucky | — | $843.35 |
| New Orleans, LALouisiana | — | $882.41 |
| Rest of LouisianaLouisiana | — | $846.18 |
| Metropolitan Boston, MAMassachusetts | — | $962.63 |
| Rest of MassachusettsMassachusetts | — | $894.58 |
| Baltimore area, MDMaryland | — | $944.11 |
| Rest of MarylandMaryland | — | $889.76 |
| Rest of MaineMaine | — | $825.35 |
| Southern Maine, MEMaine | — | $850.22 |
| Detroit, MIMichigan | — | $943.98 |
| Rest of MichiganMichigan | — | $872.26 |
| MinnesotaMinnesota | — | $830.51 |
| Metropolitan Kansas City, MOMissouri | — | $866.28 |
| Metropolitan St. Louis, MOMissouri | — | $873.10 |
| Rest of MissouriMissouri | — | $839.96 |
| MississippiMississippi | — | $816.78 |
| MontanaMontana | — | $888.94 |
| North CarolinaNorth Carolina | — | $831.40 |
| North DakotaNorth Dakota | — | $831.40 |
| NebraskaNebraska | — | $802.65 |
| New HampshireNew Hampshire | — | $890.84 |
| Northern New JerseyNew Jersey | — | $978.42 |
| Rest of New JerseyNew Jersey | — | $947.81 |
| New MexicoNew Mexico | — | $880.61 |
| NevadaNevada | — | $873.24 |
| NYC suburbs and Long Island, NYNew York | — | $1,065.37 |
| Poughkeepsie and northern NYC suburbs, NYNew York | — | $962.08 |
| Queens, NYNew York | — | $1,022.66 |
| Rest of New YorkNew York | — | $843.36 |
| OhioOhio | — | $860.50 |
| OklahomaOklahoma | — | $831.29 |
| Portland, OROregon | — | $909.03 |
| Rest of OregonOregon | — | $858.91 |
| Metropolitan Philadelphia, PAPennsylvania | — | $929.92 |
| Rest of PennsylvaniaPennsylvania | — | $856.07 |
| Puerto RicoPuerto Rico | — | $891.39 |
| Rhode IslandRhode Island | — | $898.41 |
| South CarolinaSouth Carolina | — | $848.86 |
| South DakotaSouth Dakota | — | $824.59 |
| TennesseeTennessee | — | $813.37 |
| Austin, TXTexas | — | $898.56 |
| Beaumont, TXTexas | — | $851.81 |
| Brazoria, TXTexas | — | $868.34 |
| Dallas, TXTexas | — | $878.06 |
| Fort Worth, TXTexas | — | $875.95 |
| Galveston, TXTexas | — | $873.68 |
| Houston, TXTexas | — | $926.94 |
| Rest of TexasTexas | — | $862.47 |
| UtahUtah | — | $858.94 |
| VirginiaVirginia | — | $854.81 |
| Virgin Islands, VIUnited States Virgin Islands | — | $891.39 |
| VermontVermont | — | $837.74 |
| Rest of WashingtonWashington | — | $889.72 |
| King County, WAWashington | — | $970.77 |
| WisconsinWisconsin | — | $807.68 |
| West VirginiaWest Virginia | — | $886.74 |
| WyomingWyoming | — | $863.86 |
27591 rates by state
Office rate range in each state. Select a state to see its payment localities.
Explore a state
Local rates. Clear comparisons.
Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
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.
How the rate is built · 27591
RVUs × geographic indexes × conversion factor
Work13.59
13.59 RVUs× 1.000 GPCI
Practice expense10.12
10.12 RVUs× 1.000 GPCI
Malpractice2.91
2.91 RVUs× 1.000 GPCI
Adjusted RVUs
26.6200
Conversion factor
$33.4009
Medicare rate
$889.13
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Connecticut inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
2,956
- Code
- 27591
- Physician work
- 13.59
- Practice expense
- 10.12
- Malpractice
- 2.91
GPCI2026.csv
38
- Locality
- Connecticut
- Physician work
- 1.020
- Practice expense
- 1.077
- Malpractice
- 1.210
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 13.59 | × 1.020 | 13.8618 |
| Practice expense | 10.12 | × 1.077 | 10.8992 |
| Malpractice | 2.91 | × 1.210 | 3.5211 |
| Total RVUs | 28.2821 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Connecticut$944.65
Facility: (13.59 × 1.02 + 10.12 × 1.077 + 2.91 × 1.21) × $33.4009 = $944.65
Payment rules and modifiers for 27591
27591 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 27591
Thigh amputation, primary closure
| 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 · 27591
Thigh amputation, primary closure
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
27591 without 50 · national facility
$889.13
Thigh amputation, primary closure
27591-50 · Bilateral: 150%
$1,333.70
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).
How 27591 has changed in Connecticut
27591 · Office / nonfacility
Rate unavailable
Effective 2026-10-01
A rate is unavailable in one of these releases, so a change cannot be calculated.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
What changed, release by release
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $944.65 | RVU26D |
| 2026-07-01 | Not available in this setting | $944.65 | RVU26C |
| 2026-04-01 | Not available in this setting | $944.65 | RVU26B |
| 2026-01-01 | Not available in this setting | $944.65 | RVU26A |
| 2025-10-01 | Not available in this setting | $1,017.46 | RVU25D |
| 2025-07-01 | Not available in this setting | $1,017.46 | RVU25C |
| 2025-04-01 | Not available in this setting | $1,017.46 | RVU25B |
| 2025-01-01 | Not available in this setting | $1,017.46 | RVU25A |
| 2024-10-01 | Not available in this setting | $1,037.29 | RVU24D |
| 2024-07-01 | Not available in this setting | $1,037.29 | RVU24C |
| 2024-04-01 | Not available in this setting | $1,037.29 | RVU24B |
| 2024-03-09 | Not available in this setting | $1,037.29 | RVU24AR |
| 2024-01-01 | Not available in this setting | $1,020.36 | RVU24A |
| 2023-10-01 | Not available in this setting | $1,044.04 | RVU23D |
| 2023-07-01 | Not available in this setting | $1,044.04 | RVU23C |
| 2023-04-01 | Not available in this setting | $1,044.04 | RVU23B |
| 2023-01-01 | Not available in this setting | $1,044.04 | RVU23A |
| 2022-10-01 | Not available in this setting | $1,049.41 | RVU22D |
| 2022-07-01 | Not available in this setting | $1,049.41 | RVU22C |
| 2022-04-01 | Not available in this setting | $1,049.41 | RVU22B |
| 2022-01-01 | Not available in this setting | $1,049.41 | RVU22A |
| 2021-10-01 | Not available in this setting | $1,052.52 | RVU21D |
| 2021-07-01 | Not available in this setting | $1,052.52 | RVU21C |
| 2021-04-01 | Not available in this setting | $1,052.52 | RVU21B |
| 2021-01-01 | Not available in this setting | $1,052.52 | RVU21A |
| 2020-10-01 | Not available in this setting | $1,076.52 | RVU20D |
| 2020-07-01 | Not available in this setting | $1,076.52 | RVU20C |
| 2020-04-01 | Not available in this setting | $1,076.52 | RVU20B |
| 2020-01-01 | Not available in this setting | $1,076.52 | RVU20A |
| 2019-10-01 | Not available in this setting | $1,087.98 | RVU19D |
| 2019-07-01 | Not available in this setting | $1,087.98 | RVU19C |
| 2019-04-01 | Not available in this setting | $1,083.01 | RVU19B |
| 2019-01-01 | Not available in this setting | $1,083.01 | RVU19A |
| 2018-10-01 | Not available in this setting | $1,085.38 | RVU18D |
| 2018-07-01 | Not available in this setting | $1,085.38 | RVU18C |
| 2018-04-01 | Not available in this setting | $1,085.38 | RVU18B |
| 2018-01-01 | Not available in this setting | $1,085.38 | RVU18AR1 |
| 2017-10-01 | Not available in this setting | $1,081.07 | RVU17D |
| 2017-07-01 | Not available in this setting | $1,081.07 | RVU17C |
| 2017-04-01 | Not available in this setting | $1,081.07 | RVU17B |
| 2017-01-01 | Not available in this setting | $1,081.07 | RVU17A |
| 2016-10-01 | Not available in this setting | $1,077.47 | RVU16D |
| 2016-07-01 | Not available in this setting | $1,077.47 | RVU16C |
| 2016-04-01 | Not available in this setting | $1,077.47 | RVU16B |
| 2016-01-01 | Not available in this setting | $1,077.47 | RVU16A |
| 2015-10-01 | Not available in this setting | $1,086.91 | RVU15D |
| 2015-07-01 | Not available in this setting | $1,086.91 | RVU15C |
| 2015-04-01 | Not available in this setting | $1,081.50 | RVU15B |
| 2015-01-01 | Not available in this setting | $1,081.50 | RVU15A |
| 2014-10-01 | Not available in this setting | $1,074.01 | RVU14D |
| 2014-07-01 | Not available in this setting | $1,074.01 | RVU14C |
| 2014-04-01 | Not available in this setting | $1,074.01 | RVU14B |
| 2014-01-01 | Not available in this setting | $1,074.01 | RVU14A |
| 2013-10-01 | Not available in this setting | $1,058.48 | RVU13D |
| 2013-07-01 | Not available in this setting | $1,058.48 | RVU13C |
| 2013-04-01 | Not available in this setting | $1,058.48 | RVU13B |
| 2013-01-01 | Not available in this setting | $1,058.48 | RVU13AR |
Where the Connecticut rate applies
Connecticut is a Medicare payment area, not a city. Our Census mapping connects it to 215 cities and communities in Connecticut. Some span more than one payment area; confirm with the service ZIP.
- Ansonia
- Ball Pond
- Baltic
- Bantam
- Bethel
- Bethlehem Village
- Bigelow Corners
- Blue Hills
27591 billing questions
How does this differ from 27590?
Use 27591 when the thigh amputation is closed primarily. Code 27590 describes a thigh amputation without that primary-closure distinction.
When would 27592 be selected instead?
27592 is the sibling code for a thigh amputation with immediate prosthesis fitting. Primary closure alone supports 27591, not 27592.
Is primary closure separately reported?
Primary closure is the distinguishing feature of 27591 and is included in this service; it is not a separate amputation code.
How is bilateral reporting handled?
For bilateral thigh amputations in the same session, report modifier 50; CMS pays the bilateral procedure at 150%.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeons are paid only when supporting documentation is provided.
What documentation supports this code?
Document the amputation level through the femur, laterality, clinical reason, and primary closure of the operative site.
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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