No office rate
Both describe thigh-level amputation, but 27591 specifies primary closure. Choose 27590 when that closure distinction is not documented.
On this page
CMS RVU26D · Effective 2026-10-01
27591 in Modesto
Office / nonfacility
Not available in this setting
Base rate per service
Facility setting
$884.20
Base rate per service
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
Amputation surgery
About 27591: Thigh amputation with primary closure
Reports a through-femur thigh amputation closed primarily, typically for severe limb ischemia, infection, trauma, or disease requiring removal of the limb.
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.
CMS billing rules for 27591
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral procedure with modifier 50 is paid at 150%.
- Assistant at surgery
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU13.59 · 51%
- Practice expense (office) RVU10.12 · 38%
- Malpractice RVU2.91 · 11%
15
Medicare services in 2024 · #6065 by national volume
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.
27591 compared with similar codes
Office rates for Modesto, from the same CMS release.
No office rate
Choose 27592 when immediate prosthesis fitting is part of the service; primary closure without that distinction points to 27591.
No office rate
27594 describes revision of an existing thigh amputation. Code 27591 is for the amputation itself with primary closure.
No office rate
27880 is an amputation through the tibia and fibula. Code 27591 is for an amputation through the femur.
The same code, a different location
How does Modesto compare?
27591 across payment areas
Same release and payment basis · bars start at $0
Modesto · This locality
Unavailable
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
No comparable rate is available in this setting.
Other payment areas listed in California appear first, followed by selected cross-country examples. The chart compares amounts, not distance.
The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.
Compare all 108 other payment areas
Madera
California · 27591
Office
Unavailable
Facility
$884.20
No comparable office rate is available.
Merced
California · 27591
Office
Unavailable
Facility
$884.20
No comparable office rate is available.
Napa
California · 27591
Office
Unavailable
Facility
$977.40
No comparable office rate is available.
Oxnard-Thousand Oaks-Ventura
California · 27591
Office
Unavailable
Facility
$926.72
No comparable office rate is available.
Redding
California · 27591
Office
Unavailable
Facility
$884.20
No comparable office rate is available.
Rest Of California
California · 27591
Office
Unavailable
Facility
$884.20
No comparable office rate is available.
Riverside-San Bernardino-Ontario
California · 27591
Office
Unavailable
Facility
$915.46
No comparable office rate is available.
Sacramento-Roseville-Folsom
California · 27591
Office
Unavailable
Facility
$915.47
No comparable office rate is available.
Salinas
California · 27591
Office
Unavailable
Facility
$911.85
No comparable office rate is available.
San Diego-Chula Vista-Carlsbad
California · 27591
Office
Unavailable
Facility
$924.48
No comparable office rate is available.
San Francisco-Oakland-Berkeley (Marin Cnty)
California · 27591
Office
Unavailable
Facility
$1018.26
No comparable office rate is available.
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)
California · 27591
Office
Unavailable
Facility
$1014.95
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
California · 27591
Office
Unavailable
Facility
$1043.37
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
California · 27591
Office
Unavailable
Facility
$1029.86
No comparable office rate is available.
San Luis Obispo-Paso Robles
California · 27591
Office
Unavailable
Facility
$898.73
No comparable office rate is available.
Santa Cruz-Watsonville
California · 27591
Office
Unavailable
Facility
$926.24
No comparable office rate is available.
Santa Maria-Santa Barbara
California · 27591
Office
Unavailable
Facility
$912.85
No comparable office rate is available.
Santa Rosa-Petaluma
California · 27591
Office
Unavailable
Facility
$934.72
No comparable office rate is available.
Stockton
California · 27591
Office
Unavailable
Facility
$884.20
No comparable office rate is available.
Vallejo
California · 27591
Office
Unavailable
Facility
$972.63
No comparable office rate is available.
Visalia
California · 27591
Office
Unavailable
Facility
$884.20
No comparable office rate is available.
Yuba City
California · 27591
Office
Unavailable
Facility
$884.20
No comparable office rate is available.
Dc + Md/Va Suburbs
District of Columbia · 27591
Office
Unavailable
Facility
$984.79
No comparable office rate is available.
Miami
Florida · 27591
Office
Unavailable
Facility
$1051.60
No comparable office rate is available.
Chicago
Illinois · 27591
Office
Unavailable
Facility
$1019.87
No comparable office rate is available.
Manhattan
New York · 27591
Office
Unavailable
Facility
$1029.90
No comparable office rate is available.
Alaska*
Alaska · 27591
Office
Unavailable
Facility
$1094.42
No comparable office rate is available.
Alabama
Alabama · 27591
Office
Unavailable
Facility
$804.70
No comparable office rate is available.
Arkansas
Arkansas · 27591
Office
Unavailable
Facility
$794.33
No comparable office rate is available.
Arizona
Arizona · 27591
Office
Unavailable
Facility
$864.66
No comparable office rate is available.
Colorado
Colorado · 27591
Office
Unavailable
Facility
$894.93
No comparable office rate is available.
Connecticut
Connecticut · 27591
Office
Unavailable
Facility
$944.65
No comparable office rate is available.
Delaware
Delaware · 27591
Office
Unavailable
Facility
$877.53
No comparable office rate is available.
Fort Lauderdale
Florida · 27591
Office
Unavailable
Facility
$972.06
No comparable office rate is available.
Rest Of Florida
Florida · 27591
Office
Unavailable
Facility
$923.15
No comparable office rate is available.
Atlanta
Georgia · 27591
Office
Unavailable
Facility
$915.44
No comparable office rate is available.
Rest Of Georgia
Georgia · 27591
Office
Unavailable
Facility
$871.29
No comparable office rate is available.
Hawaii, Guam
Hawaii · 27591
Office
Unavailable
Facility
$894.52
No comparable office rate is available.
Iowa
Iowa · 27591
Office
Unavailable
Facility
$801.79
No comparable office rate is available.
Idaho
Idaho · 27591
Office
Unavailable
Facility
$810.87
No comparable office rate is available.
East St. Louis
Illinois · 27591
Office
Unavailable
Facility
$960.65
No comparable office rate is available.
Rest Of Illinois
Illinois · 27591
Office
Unavailable
Facility
$914.45
No comparable office rate is available.
Suburban Chicago
Illinois · 27591
Office
Unavailable
Facility
$976.47
No comparable office rate is available.
Indiana
Indiana · 27591
Office
Unavailable
Facility
$814.50
No comparable office rate is available.
Kansas
Kansas · 27591
Office
Unavailable
Facility
$808.47
No comparable office rate is available.
Kentucky
Kentucky · 27591
Office
Unavailable
Facility
$843.35
No comparable office rate is available.
New Orleans
Louisiana · 27591
Office
Unavailable
Facility
$882.41
No comparable office rate is available.
Rest Of Louisiana
Louisiana · 27591
Office
Unavailable
Facility
$846.18
No comparable office rate is available.
Metropolitan Boston
Massachusetts · 27591
Office
Unavailable
Facility
$962.63
No comparable office rate is available.
Rest Of Massachusetts
Massachusetts · 27591
Office
Unavailable
Facility
$894.58
No comparable office rate is available.
Baltimore/Surr. Cntys
Maryland · 27591
Office
Unavailable
Facility
$944.11
No comparable office rate is available.
Rest Of Maryland
Maryland · 27591
Office
Unavailable
Facility
$889.76
No comparable office rate is available.
Rest Of Maine
Maine · 27591
Office
Unavailable
Facility
$825.35
No comparable office rate is available.
Southern Maine
Maine · 27591
Office
Unavailable
Facility
$850.22
No comparable office rate is available.
Detroit
Michigan · 27591
Office
Unavailable
Facility
$943.98
No comparable office rate is available.
Rest Of Michigan
Michigan · 27591
Office
Unavailable
Facility
$872.26
No comparable office rate is available.
Minnesota
Minnesota · 27591
Office
Unavailable
Facility
$830.51
No comparable office rate is available.
Metropolitan Kansas City
Missouri · 27591
Office
Unavailable
Facility
$866.28
No comparable office rate is available.
Metropolitan St. Louis
Missouri · 27591
Office
Unavailable
Facility
$873.10
No comparable office rate is available.
Rest Of Missouri
Missouri · 27591
Office
Unavailable
Facility
$839.96
No comparable office rate is available.
Mississippi
Mississippi · 27591
Office
Unavailable
Facility
$816.78
No comparable office rate is available.
Montana**
Montana · 27591
Office
Unavailable
Facility
$888.94
No comparable office rate is available.
North Carolina
North Carolina · 27591
Office
Unavailable
Facility
$831.40
No comparable office rate is available.
North Dakota**
North Dakota · 27591
Office
Unavailable
Facility
$831.40
No comparable office rate is available.
Nebraska
Nebraska · 27591
Office
Unavailable
Facility
$802.65
No comparable office rate is available.
New Hampshire
New Hampshire · 27591
Office
Unavailable
Facility
$890.84
No comparable office rate is available.
Northern Nj
New Jersey · 27591
Office
Unavailable
Facility
$978.42
No comparable office rate is available.
Rest Of New Jersey
New Jersey · 27591
Office
Unavailable
Facility
$947.81
No comparable office rate is available.
New Mexico
New Mexico · 27591
Office
Unavailable
Facility
$880.61
No comparable office rate is available.
Nevada**
Nevada · 27591
Office
Unavailable
Facility
$873.24
No comparable office rate is available.
Nyc Suburbs/Long Island
New York · 27591
Office
Unavailable
Facility
$1065.37
No comparable office rate is available.
Poughkpsie/N Nyc Suburbs
New York · 27591
Office
Unavailable
Facility
$962.08
No comparable office rate is available.
Queens
New York · 27591
Office
Unavailable
Facility
$1022.66
No comparable office rate is available.
Rest Of New York
New York · 27591
Office
Unavailable
Facility
$843.36
No comparable office rate is available.
Ohio
Ohio · 27591
Office
Unavailable
Facility
$860.50
No comparable office rate is available.
Oklahoma
Oklahoma · 27591
Office
Unavailable
Facility
$831.29
No comparable office rate is available.
Portland
Oregon · 27591
Office
Unavailable
Facility
$909.03
No comparable office rate is available.
Rest Of Oregon
Oregon · 27591
Office
Unavailable
Facility
$858.91
No comparable office rate is available.
Metropolitan Philadelphia
Pennsylvania · 27591
Office
Unavailable
Facility
$929.92
No comparable office rate is available.
Rest Of Pennsylvania
Pennsylvania · 27591
Office
Unavailable
Facility
$856.07
No comparable office rate is available.
Puerto Rico
Puerto Rico · 27591
Office
Unavailable
Facility
$891.39
No comparable office rate is available.
Rhode Island
Rhode Island · 27591
Office
Unavailable
Facility
$898.41
No comparable office rate is available.
South Carolina
South Carolina · 27591
Office
Unavailable
Facility
$848.86
No comparable office rate is available.
South Dakota**
South Dakota · 27591
Office
Unavailable
Facility
$824.59
No comparable office rate is available.
Tennessee
Tennessee · 27591
Office
Unavailable
Facility
$813.37
No comparable office rate is available.
Austin
Texas · 27591
Office
Unavailable
Facility
$898.56
No comparable office rate is available.
Beaumont
Texas · 27591
Office
Unavailable
Facility
$851.81
No comparable office rate is available.
Brazoria
Texas · 27591
Office
Unavailable
Facility
$868.34
No comparable office rate is available.
Dallas
Texas · 27591
Office
Unavailable
Facility
$878.06
No comparable office rate is available.
Fort Worth
Texas · 27591
Office
Unavailable
Facility
$875.95
No comparable office rate is available.
Galveston
Texas · 27591
Office
Unavailable
Facility
$873.68
No comparable office rate is available.
Houston
Texas · 27591
Office
Unavailable
Facility
$926.94
No comparable office rate is available.
Rest Of Texas
Texas · 27591
Office
Unavailable
Facility
$862.47
No comparable office rate is available.
Utah
Utah · 27591
Office
Unavailable
Facility
$858.94
No comparable office rate is available.
Virginia
Virginia · 27591
Office
Unavailable
Facility
$854.81
No comparable office rate is available.
Virgin Islands
United States Virgin Islands · 27591
Office
Unavailable
Facility
$891.39
No comparable office rate is available.
Vermont
Vermont · 27591
Office
Unavailable
Facility
$837.74
No comparable office rate is available.
Rest Of Washington
Washington · 27591
Office
Unavailable
Facility
$889.72
No comparable office rate is available.
Seattle (King Cnty)
Washington · 27591
Office
Unavailable
Facility
$970.77
No comparable office rate is available.
Wisconsin
Wisconsin · 27591
Office
Unavailable
Facility
$807.68
No comparable office rate is available.
West Virginia
West Virginia · 27591
Office
Unavailable
Facility
$886.74
No comparable office rate is available.
Wyoming**
Wyoming · 27591
Office
Unavailable
Facility
$863.86
No comparable office rate is available.
See how rates vary across the country
27591 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.
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 all state and territory rates as a table
| State / territory | 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 |
Where does this rate apply?
Modesto is a Medicare payment area. Our Census mapping connects it to 33 cities and communities in California, including the examples shown here.
Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.
Use this rate
What is a percentage of Medicare worth?
Turn a percentage into dollars for 27591 in Modesto. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$972.62
$884.20 × 110% = $972.62
A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.
Working with a whole code list?
Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.
How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 27591 in Modesto.
PPRRVU2026_Oct_nonQPP.csv
2,956
- Code
- 27591
- Physician work
- 13.59
- Practice expense
- 10.12
- Malpractice
- 2.91
GPCI2026.csv
16
- Locality
- Modesto
- Physician work
- 1.017
- Practice expense
- 1.096
- Malpractice
- 0.536
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 13.59 | × 1.017 | 13.8210 |
| Practice expense | 10.12 | × 1.096 | 11.0915 |
| Malpractice | 2.91 | × 0.536 | 1.5598 |
| Total RVUs | 26.4723 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Modesto$884.20
Open 27591 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 13.59 | 1.017 |
| Practice expense | 10.12 | 1.096 |
| Malpractice | 2.91 | 0.536 |
(13.59 × 1.017 + 10.12 × 1.096 + 2.91 × 0.536) × $33.4009 = $884.20
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
How this rate has changed
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
Explore release dates and calculate this code in an earlier period →
Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.
Inspect every release and its CMS source
| Effective from | Office / nonfacility | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $884.20 | RVU26D |
| 2026-07-01 | Not available in this setting | $884.20 | RVU26C |
| 2026-04-01 | Not available in this setting | $884.20 | RVU26B |
| 2026-01-01 | Not available in this setting | $884.20 | RVU26A |
| 2025-10-01 | Not available in this setting | $955.02 | RVU25D |
| 2025-07-01 | Not available in this setting | $955.02 | RVU25C |
| 2025-04-01 | Not available in this setting | $955.02 | RVU25B |
| 2025-01-01 | Not available in this setting | $955.02 | RVU25A |
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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
2,95327570,,Fixation of knee joint,A,,1.75,2.37,NA,2.37,,0.37,4.49,4.49,0,010,0.10,0.80,0.10,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,95427580,,Fusion of knee,A,,20.57,15.63,NA,15.63,,4.36,40.56,40.56,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,95527590,,Amputate leg at thigh,A,,13.13,5.19,NA,5.19,,3.27,21.59,21.59,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,95627591,,Amputate leg at thigh,A,,13.59,10.12,NA,10.12,,2.91,26.62,26.62,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,95727592,,Amputate leg at thigh,A,,10.71,5.49,NA,5.49,,2.61,18.81,18.81,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,95827594,,Amputation follow-up surgery,A,,7.11,5.53,NA,5.53,,1.67,14.31,14.31,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,95927596,,Amputation follow-up surgery,A,,11.01,6.11,NA,6.11,,2.64,19.76,19.76,0,090,0.10,0.69,0.21,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1301182,CA,18,LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY),1.041,1.183,0.664
1401112,CA,58,MADERA,1.017,1.096,0.536
1501112,CA,59,MERCED,1.017,1.096,0.536
1601112,CA,60,MODESTO,1.017,1.096,0.536
1701112,CA,51,NAPA,1.063,1.318,0.508
1801182,CA,17,OXNARD-THOUSAND OAKS-VENTURA,1.028,1.182,0.623
1901112,CA,61,REDDING,1.017,1.096,0.536