CPT code 27594: Amputation revision, thigh-level stump2026 Medicare rate & RVUs in Missouri
Revision surgery for an existing thigh-level amputation stump, reported when the surgeon modifies the residual limb rather than performing an initial amputation.
CMS doesn’t publish an office rate for 27594 in Missouri.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 sections
What 27594 covers
This service revises an existing amputation stump at the thigh or femur level. The surgeon may remove problematic tissue or bone and reshape the residual limb to address issues such as a painful bony prominence, tissue breakdown, or difficulty fitting a prosthesis. Orthopedic and vascular surgeons commonly perform this operation in a hospital or other surgical setting.
Report the code for revision of an established thigh-level stump, not for the original amputation. The operative note should identify the existing amputation level, the problem prompting revision, and the work performed on the residual limb. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same 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%. Medicare does not pay an assistant at surgery for this code; co-surgeons and team surgery are 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 27594 pays more and less in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | Unavailable | $465.42 |
| Metropolitan St. Louis, MO | Unavailable | $469.21 |
| Rest of Missouri | Unavailable | $451.03 |
How the 27594 rate is calculated
Each of 27594’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 · 27594
RVUs × geographic indexes × conversion factor
Work7.11
7.11 RVUs× 1.000 GPCI
Practice expense5.53
5.53 RVUs× 1.000 GPCI
Malpractice1.67
1.67 RVUs× 1.000 GPCI
Adjusted RVUs
14.3100
Conversion factor
$33.4009
Medicare rate
$477.97
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 27594
27594 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 27594
Amputation revision, thigh-level stump
| 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) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| 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 · 27594
Amputation revision, thigh-level stump
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
27594 without 50 · national facility
$477.97
Amputation revision, thigh-level stump
27594-50 · Bilateral: 150%
$716.96
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).
27594 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 27590Thigh amputationThrough femur, any level
- 27590 is for the initial thigh-level amputation. Use 27594 when the patient already has an amputation stump that is being revised.
- 27592Thigh amputationImmediate prosthesis fitting
- 27592 describes thigh-level re-amputation; 27594 describes revision of an existing stump. The operative report should support which service was performed.
- 27596Amputation revisionThigh-level re-amputation
- 27596 is the corresponding revision code for an amputation at the leg level. 27594 is for a thigh-level stump.
27594 billing questions
How is this different from 27590?
27590 describes an initial thigh-level amputation. Report 27594 when the patient already has a thigh-level amputation and the surgeon revises that stump.
When would 27592 be considered instead?
27592 describes re-amputation at the thigh level, while 27594 describes revision of an existing stump. Use the operative documentation to determine whether the service is a re-amputation or a stump revision.
Are related postoperative visits separately reported?
The 90-day global period includes related postoperative care for 90 days and the day-before preoperative visit.
Can an assistant or co-surgeon be billed?
Medicare does not pay an assistant at surgery for this code. Co-surgeons and team surgery are not permitted.
How does Medicare handle bilateral reporting?
When the procedure is performed bilaterally and reported with modifier 50, Medicare pays at 150%.
What happens when another procedure is performed in the same session?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple procedure reduction.
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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