CPT code 27590: Thigh amputation2026 Medicare rate & RVUs in Guam
Reports surgical removal of the lower limb through the femur at any level, commonly for nonviable tissue, severe infection, trauma, or malignancy.
CMS doesn’t publish an office rate for 27590 in Guam.
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 27590 covers
The surgeon removes the lower limb through the femur, with the level selected according to the extent of disease or injury and the tissue available for a residual limb. Typical cases include a limb rendered nonviable by advanced ischemia, extensive infection, major trauma, or a tumor requiring removal. These operations are generally performed in a hospital operating room by an orthopedic, vascular, or general surgeon, depending on the underlying condition.
Choose the code that matches the operative technique and closure: this code is distinct from the related thigh-amputation codes for primary closure or an open circular procedure. The operative report should identify the femoral level, indication, and closure approach. 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 others at 50%. For bilateral procedures reported with modifier 50, CMS pays 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.
27590 in Hawaii, Guam
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam | Unavailable | $698.89 |
How the 27590 rate is calculated
Each of 27590’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 · 27590
RVUs × geographic indexes × conversion factor
Work13.13
13.13 RVUs× 1.000 GPCI
Practice expense5.19
5.19 RVUs× 1.000 GPCI
Malpractice3.27
3.27 RVUs× 1.000 GPCI
Adjusted RVUs
21.5900
Conversion factor
$33.4009
Medicare rate
$721.13
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 27590
27590 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 27590
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 · 27590
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
27590 without 50 · national facility
$721.13
Thigh amputation
27590-50 · Bilateral: 150%
$1,081.70
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).
27590 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 27591Thigh amputation
- This code is for a thigh amputation with primary closure. Select it when primary closure is documented rather than reporting 27590.
- 27592Thigh amputation
- This code describes an open, circular thigh amputation. The operative technique, not just the indication for amputation, distinguishes it from 27590.
- 27594Amputation revision
- This code is for re-amputation through the femur. Use 27590 for the initial thigh amputation, not a subsequent re-amputation.
- 27598Leg amputation
- This code describes amputation at the knee joint through the tibia and fibula. Code 27590 is for amputation through the femur.
27590 billing questions
How is this code distinguished from 27591?
Use the code that matches the documented closure approach. Code 27591 identifies thigh amputation with primary closure; this code does not describe that primary-closure variation.
When is 27592 a better fit?
Code 27592 describes an open, circular thigh amputation. Use this code when the operative report supports the standard thigh-amputation service rather than that open circular technique.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation, and CMS does not permit team surgery for this service.
How does CMS handle bilateral procedures and other procedures in the same session?
For a bilateral procedure reported with modifier 50, CMS pays at 150%. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others at 50%.
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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