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Billing code 27594: Amputation revisionMedicare rate & RVUs

Revision surgery for an existing thigh-level amputation stump, reported when the surgeon modifies the residual limb rather than performing an initial amputation.

CMS RVU26DEffective Oct 1, 2026109 payment localities201 Medicare services in 2024

Medicare pays $477.97 for 27594 nationally in a facility.

Medicare rate · 27594

Amputation revision

Swap in your local Medicare rate.

Work RVUs
7.11
Total RVUs
14.31
Global days
090

National rate · 2026

$477.97

Facility setting, before claim adjustments.

See every locality for 27594 → · Billed by an NP, PA or therapist? →

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 10 sections
  1. Medicare rate
  2. What 27594 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

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

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

109 of 109 payment localities

27594 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$430.67
Alaska*Unavailable$583.67
ArizonaUnavailable$464.21
ArkansasUnavailable$424.87
AtlantaUnavailable$492.85
AustinUnavailable$482.80
BakersfieldUnavailable$478.40
Baltimore/Surr. CntysUnavailable$508.47
BeaumontUnavailable$457.38
BrazoriaUnavailable$465.93

27594 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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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
27594 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

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

Swap in your local Medicare rate.

Work 7.11Practice expense 5.53Malpractice 1.67

14.3100 adjusted RVUs×$33.4009 conversion factor=$477.97

All indexes start 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

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.69/0.21Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 27594

Amputation revision

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.

  • 24 Unrelated E/M visit by the same physician
  • 79 Unrelated procedure (starts its own global period)
  • 58 Staged, more extensive, or therapy procedure that was planned
  • 78 Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

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

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).

When to use modifier 50

27594 compared with similar codes

Compare codes

27594 vs 27590 vs 27592 vs 27596: national Medicare rates

Swap in your local Medicare rate.

  • 27594
    Amputation revision · 7.11 wRVU
    —
  • 27590
    Thigh amputation · 13.13 wRVU
    —
  • 27592
    Thigh amputation · 10.71 wRVU
    —
  • 27596
    Amputation revision · 11.01 wRVU
    —

How to choose

27590Thigh amputation
27590 is for the initial thigh-level amputation. Use 27594 when the patient already has an amputation stump that is being revised.
27592Thigh amputation
27592 describes thigh-level re-amputation; 27594 describes revision of an existing stump. The operative report should support which service was performed.
27596Amputation revision
27596 is the corresponding revision code for an amputation at the leg level. 27594 is for a thigh-level stump.

Codes related to 27594

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

Codes related to 27594
CodeHow it relatesNational office range
Used instead
27590Thigh amputationUsed for an initial thigh-level amputation rather than revision of an existing stump.No office rate
27591Thigh amputationInitial thigh-level amputation with immediate prosthesis fitting, not stump revision.No office rate
27592Thigh amputationThigh-level re-amputation; distinguish from revision of an established stump.No office rate
27598Leg amputationAmputation at the knee level, not revision of a thigh-level stump.No office rate
Same family
27596Amputation revisionRevision code for an amputation at the leg level rather than the thigh.No office rate

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
RVUs for 27594PPRRVU2026_Oct_nonQPP.csv, line 2,958 (RVU26D)

Open CMS sourceHow we calculate rates

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