Billing code 27591: Thigh amputationMedicare rate & RVUs in Florida
Reports a through-femur thigh amputation closed primarily, typically for severe limb ischemia, infection, trauma, or disease requiring removal of the limb.
CMS doesn’t publish an office rate for 27591 in Florida.
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 27591 covers
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.
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 27591 pays more and less in Florida
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Fort Lauderdale | Unavailable | $972.06 |
| Miami | Unavailable | $1,051.60 |
| Rest Of Florida | Unavailable | $923.15 |
How the 27591 rate is calculated
Each of 27591’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 · 27591
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 13.59Practice expense 10.12Malpractice 2.91
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 27591
27591 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 27591
Thigh 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 · 27591
Thigh 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
27591 without 50 · national facility
$889.13
Thigh amputation
27591-50 · Bilateral: 150%
$1,333.70
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).
27591 compared with similar codes
Compare codes
27591 vs 27590 vs 27592 vs 27594 vs 27880: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 27590Thigh amputation
- Both describe thigh-level amputation, but 27591 specifies primary closure. Choose 27590 when that closure distinction is not documented.
- 27592Thigh amputation
- Choose 27592 when immediate prosthesis fitting is part of the service; primary closure without that distinction points to 27591.
- 27594Amputation revision
- 27594 describes revision of an existing thigh amputation. Code 27591 is for the amputation itself with primary closure.
- 27880Leg amputation
- 27880 is an amputation through the tibia and fibula. Code 27591 is for an amputation through the femur.
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 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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