Billing code 27592: Thigh amputationMedicare rate & RVUs in Guam
Reports a transfemoral amputation performed with immediate prosthesis fitting, distinguishing it from thigh amputations without that fitting circumstance.
CMS doesn’t publish an office rate for 27592 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 27592 covers
This service is a transfemoral amputation, removing the lower limb through the femur, with immediate fitting of a prosthesis as part of the operative episode. Orthopedic or vascular surgeons may perform it in a hospital operating room for conditions such as nonviable tissue from severe trauma, advanced infection, or critical limb ischemia. The operative record should identify the amputation level and document the immediate prosthesis fitting.
Select this code when that immediate fitting accompanies the thigh amputation; codes 27590 and 27591 describe other thigh-amputation circumstances. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. In a same-session multiple-procedure claim, the highest-valued procedure is paid in full and others at 50%. Modifier 50 indicates a bilateral procedure 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.
27592 in Hawaii, Guam
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam | Unavailable | $616.69 |
How the 27592 rate is calculated
Each of 27592’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 · 27592
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 10.71Practice expense 5.49Malpractice 2.61
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 27592
27592 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 27592
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 · 27592
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
27592 without 50 · national facility
$628.27
Thigh amputation
27592-50 · Bilateral: 150%
$942.41
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).
27592 compared with similar codes
Compare codes
27592 vs 27590 vs 27591 vs 27598: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 27590Thigh amputation
- Both describe thigh-level amputation, but 27592 is distinguished by immediate prosthesis fitting. Use 27590 for the other circumstance described by that code.
- 27591Thigh amputation
- This is another thigh-amputation code, distinguished by primary closure. Choose 27592 when immediate prosthesis fitting is the documented circumstance.
- 27598Leg amputation
- 27598 describes amputation through the lower leg at the knee level; 27592 is for an amputation through the femur with immediate prosthesis fitting.
27592 billing questions
How does this differ from 27590 or 27591?
Use 27592 when the thigh amputation includes immediate prosthesis fitting. Codes 27590 and 27591 represent other thigh-amputation circumstances; check the operative record for the defining closure or fitting detail.
Does a prosthesis fitted later in rehabilitation support 27592?
No. The distinguishing circumstance is immediate fitting with the amputation, not a prosthesis fitted during a later rehabilitation episode.
What documentation supports this code?
Document the transfemoral amputation level and the immediate prosthesis fitting in the operative record. The record should make clear that fitting occurred as part of the operative episode.
How does the 90-day global period affect postoperative billing?
The global period includes the day-before preoperative visit and 90 days of related postoperative care. Those services are part of the surgical global package.
Can modifier 50 be used for bilateral thigh amputations?
CMS lists this as a bilateral procedure; modifier 50 is paid at 150%. The operative documentation should support bilateral procedures.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation, while team surgery is not permitted for this code.
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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