Billing code 27881: Below-knee amputationMedicare rate & RVUs in Delaware
Reports a below-knee amputation with immediate prosthetic fitting and initial cast application during the operative episode.
CMS doesn’t publish an office rate for 27881 in Delaware.
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 9 sections
What 27881 covers
This service combines removal of the lower leg below the knee with immediate prosthetic fitting and application of the first cast. It is generally performed in an operating room by an orthopedic, vascular, or trauma surgeon when the lower leg is nonviable or unsalvageable, such as with critical ischemia, severe infection, or major injury. The defining feature is immediate fitting at the operative episode, not simply the amputation level.
Report 27881 when the operative record supports both the amputation and immediate prosthetic fitting with the first cast; without immediate fitting, 27880 is the closer code. The 90-day global includes the day-before preoperative visit and related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures at 50%. Bilateral reporting with modifier 50 is paid at 150%. An assistant at surgery may be paid; co-surgeon payment requires 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.
27881 in Delaware
| Payment locality | Office | Facility |
|---|---|---|
| Delaware | Unavailable | $747.76 |
How the 27881 rate is calculated
Each of 27881’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 · 27881
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 13.13Practice expense 6.41Malpractice 3.18
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 27881
27881 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 27881
Below-knee amputation
| 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 · 27881
Below-knee 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.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
27881 without 50 · national facility
$758.87
Below-knee amputation
27881-50 · Bilateral: 150%
$1,138.31
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).
27881 compared with similar codes
Compare codes
27881 vs 27880 vs 27882 vs 27888 vs 27889: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 27880Leg amputation
- Both describe a below-knee amputation, but 27881 includes immediate prosthetic fitting and the first cast. Choose 27880 when that immediate fitting is not performed.
- 27882Lower-leg amputation
- This is a related below-knee amputation code with a different operative approach. Select based on the procedure documented, not simply the amputation level.
- 27888Foot amputation
- This code is for amputation at the ankle, a more distal level than the below-knee amputation reported with 27881.
- 27889Ankle amputation
- This code describes ankle disarticulation; 27881 is for a below-knee amputation with immediate prosthetic fitting.
27881 billing questions
When should 27881 be chosen instead of 27880?
Use 27881 when immediate prosthetic fitting and application of the first cast accompany the below-knee amputation. Without that immediate fitting, 27880 is the closer code.
Is the first cast separately reported?
The first cast application is included in 27881. The operative documentation should support the immediate fitting and cast application.
How is bilateral surgery reported?
Report modifier 50 for a bilateral procedure. CMS pays the bilateral procedure at 150%.
What postoperative care is included?
The 90-day global includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be paid?
An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full, and other procedures are paid at 50% under 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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