No office rate
Both concern amputation at the ankle region, so use the operative description to determine whether the service is ankle disarticulation or the foot-amputation procedure represented by 27888.
On this page
CMS RVU26D · Effective 2026-10-01
27889 Ankle amputation Medicare reimbursement rates in Guam
Reports surgical removal of the foot through the ankle joint, generally for a nonviable or severely damaged foot when the amputation level is at the ankle. Compare 27889 office and facility rates across CMS payment localities in Guam.
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.
What does Medicare pay for 27889 in Guam?
Guam has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$588.08
1 of 1 localities have a supported rate.
Payment area: Hawaii, Guam
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Amputation surgery
About 27889: Ankle-level disarticulation amputation
Reports surgical removal of the foot through the ankle joint, generally for a nonviable or severely damaged foot when the amputation level is at the ankle.
This service removes the foot by disarticulating it at the ankle, leaving the lower leg in place. It may be performed for a foot rendered nonviable by severe infection, poor circulation, or traumatic injury when the ankle level is selected. An orthopedic or vascular surgeon typically performs the operation in a hospital operating room; the operative report should identify the level and describe the disarticulation and management of the residual tissues.
Report the code when the procedure is an ankle disarticulation, rather than a more proximal amputation through the tibia and fibula. The operative note should establish the anatomic level and support why that level was chosen. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment is restricted; co-surgeons require supporting documentation, and team surgery is not permitted.
CMS billing rules for 27889
- 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
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU10.59 · 59%
- Practice expense (office) RVU5.00 · 28%
- Malpractice RVU2.30 · 13%
183
Medicare services in 2024 · #4402 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.
27889 compared with similar codes
Office rates for Guam, from the same CMS release.
No office rate
27880 is for an amputation through the tibia and fibula, above the ankle; 27889 is the ankle-level disarticulation.
No office rate
27884 describes revision of a below-knee amputation, not the initial ankle disarticulation reported with 27889.
Compare 27889 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Hawaii, Guam →
Office / nonfacility
Unavailable
Facility
$588.08
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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 27889 in Hawaii, Guam.
PPRRVU2026_Oct_nonQPP.csv
3,082
- Code
- 27889
- Physician work
- 10.59
- Practice expense
- 5.00
- Malpractice
- 2.30
GPCI2026.csv
46
- Locality
- Hawaii, Guam
- Physician work
- 1.000
- Practice expense
- 1.137
- Malpractice
- 0.579
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 10.59 | × 1.000 | 10.5900 |
| Practice expense | 5.00 | × 1.137 | 5.6850 |
| Malpractice | 2.30 | × 0.579 | 1.3317 |
| Total RVUs | 17.6067 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Hawaii, Guam$588.08
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 10.59 | 1 |
| Practice expense | 5 | 1.137 |
| Malpractice | 2.3 | 0.579 |
(10.59 × 1 + 5 × 1.137 + 2.3 × 0.579) × $33.4009 = $588.08
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.
27889 billing questions
How is this different from a below-knee amputation?
This code describes disarticulation at the ankle. A below-knee amputation, such as 27880 or 27881, removes the leg through the tibia and fibula.
How do I distinguish this from 27888?
Choose based on the operative procedure and its documented level: 27889 is ankle disarticulation, while 27888 describes a foot amputation at the ankle. The operative report should make the distinction clear.
Are related postoperative visits included?
Yes. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How is bilateral performance reported?
CMS identifies this as a bilateral procedure; reporting modifier 50 is paid at 150% under the supplied fee schedule rule.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment is subject to a statutory restriction. Co-surgeons are paid only when supporting documentation is provided; team surgery is not permitted.
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.
3,07927884,,Amputation follow-up surgery,A,,8.54,5.81,NA,5.81,,2.05,16.40,16.40,0,090,0.10,0.69,0.21,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,08027886,,Amputation follow-up surgery,A,,9.77,5.89,NA,5.89,,2.36,18.02,18.02,0,090,0.10,0.69,0.21,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,08127888,,Amputation of foot at ankle,A,,10.11,3.27,NA,3.27,,2.58,15.96,15.96,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,08227889,,Ankle disarticulation,A,,10.59,5.00,NA,5.00,,2.30,17.89,17.89,0,090,0.10,0.69,0.21,2,1,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,08327892,,Decompression of leg,A,,7.74,6.14,NA,6.14,,1.63,15.51,15.51,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,08427893,,Decompression of leg,A,,7.70,8.25,NA,8.25,,1.64,17.59,17.59,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,08527894,,Decompression of leg,A,,12.35,7.53,NA,7.53,,2.79,22.67,22.67,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503
4410212,GA,01,ATLANTA,1.003,1.016,1.201
4510212,GA,99,REST OF GEORGIA,1.000,0.892,1.192
4601212,HI,01,"HAWAII, GUAM",1.000,1.137,0.579
4702202,ID,00,IDAHO,1.000,0.920,0.473
4806102,IL,16,CHICAGO,1.007,1.005,2.295
4906102,IL,12,EAST ST. LOUIS,1.000,0.920,2.014