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Billing code 27598: Leg amputationMedicare rate & RVUs

Removal of the lower leg through the knee joint is reported for a knee-disarticulation amputation, rather than an amputation through the femur.

CMS RVU26DEffective Oct 1, 2026109 payment localities355 Medicare services in 2024

Medicare pays $645.31 for 27598 nationally in a facility.

Medicare rate · 27598

Leg amputation

Swap in your local Medicare rate.

Work RVUs
10.94
Total RVUs
19.32
Global days
090

National rate · 2026

$645.31

Facility setting, before claim adjustments.

See every locality for 27598 → · 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 27598 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 27598 covers

At knee-disarticulation surgery, the surgeon separates the lower leg through the knee joint, leaving the femur intact. Orthopedic, vascular, or trauma surgeons may perform this operation for nonviable tissue from severe limb ischemia or infection, or for devastating injury, generally in an operating room. The operative report should establish the amputation level; a cut through the tibia below the knee or through the femur above the knee is a different level.

Report the service for the through-knee procedure and document the indication, operative level, and side. 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 the others at 50%. For bilateral surgery, modifier 50 is paid at 150%. An assistant at surgery may be paid; co-surgeons require 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 27598 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

27598 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$582.76
Alaska*Unavailable$800.36
ArizonaUnavailable$626.55
ArkansasUnavailable$575.16
AtlantaUnavailable$667.38
AustinUnavailable$646.93
BakersfieldUnavailable$635.69
Baltimore/Surr. CntysUnavailable$686.21
BeaumontUnavailable$621.81
BrazoriaUnavailable$626.89

27598 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
27598 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 27598 rate is calculated

Each of 27598’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 · 27598

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 10.94Practice expense 5.71Malpractice 2.67

19.3200 adjusted RVUs×$33.4009 conversion factor=$645.31

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 27598

27598 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 27598

Leg amputation

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)2Paid.
Co-surgeons (62)1Permitted with supporting documentation.
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 · 27598

Leg amputation

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

27598 without 50 · national facility

$645.31

Leg amputation

27598-50 · Bilateral: 150%

$967.96

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

27598 compared with similar codes

Compare codes

27598 vs 27590 vs 27591 vs 27592: national Medicare rates

Swap in your local Medicare rate.

  • 27598
    Leg amputation · 10.94 wRVU
    —
  • 27590
    Thigh amputation · 13.13 wRVU
    —
  • 27591
    Thigh amputation · 13.59 wRVU
    —
  • 27592
    Thigh amputation · 10.71 wRVU
    —

How to choose

27590Thigh amputation
Choose 27598 for disarticulation through the knee joint. Code 27590 describes an amputation through the femur.
27591Thigh amputation
Code 27591 is a femoral-level amputation with primary closure, not a through-knee amputation.
27592Thigh amputation
Code 27592 describes an open, circular amputation through the femur; 27598 is performed through the knee joint.

Codes related to 27598

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

Codes related to 27598
CodeHow it relatesNational office range
Used instead
27590Thigh amputationFemoral-level amputation is used when the operative level is above the knee joint.No office rate
27591Thigh amputationFemoral-level amputation with primary closure; the operative level is above the knee joint.No office rate
27592Thigh amputationOpen, circular femoral-level amputation; the operative level is above the knee joint.No office rate

27598 billing questions

How does 27598 differ from 27590?

27598 is an amputation through the knee joint. Code 27590 describes an amputation through the femur, above the knee.

Does the 90-day global period include postoperative care?

Yes. The global period includes the day-before preoperative visit and 90 days of related postoperative care.

How is a bilateral through-knee amputation reported?

For bilateral surgery, 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 with supporting documentation, and team surgery is not permitted.

What documentation supports this code?

The operative report should establish that the amputation was performed through the knee joint and identify the indication and side.

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 27598PPRRVU2026_Oct_nonQPP.csv, line 2,960 (RVU26D)

Open CMS sourceHow we calculate rates

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