No office rate
Choose 27882 for the open circular guillotine technique. Code 27880 describes a lower-leg amputation without that specific technique.
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CMS RVU26D · Effective 2026-10-01
27882 Lower-leg amputation Medicare reimbursement rates in Iowa
Reports an open, circular amputation through the tibia and fibula, commonly performed as an initial stage when infection or tissue damage requires leaving the wound open. Compare 27882 office and facility rates across CMS payment localities in Iowa.
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 27882 in Iowa?
Iowa 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
$491.43
1 of 1 localities have a supported rate.
Payment area: Iowa
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 27882: Open guillotine below-knee amputation
Reports an open, circular amputation through the tibia and fibula, commonly performed as an initial stage when infection or tissue damage requires leaving the wound open.
This code describes a guillotine-style amputation through the tibia and fibula, with the surgical site left open rather than closed with definitive flaps. Surgeons may use this staged approach when severe infection, gangrene, or other tissue damage makes immediate closure unsuitable. The procedure is typically performed in an operating room by an orthopedic, vascular, or general surgeon.
Report the code when the operative documentation supports an open circular technique at the lower-leg level; distinguish it from a closed below-knee amputation and one performed with immediate fitting and a rigid dressing. The major-surgery global period includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued is paid in full and other procedures are reduced to 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery and co-surgeon payment require their respective supporting documentation; team surgery is not permitted.
CMS billing rules for 27882
- 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
- Assistant at surgery is paid only with documentation of medical necessity.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU9.55 · 58%
- Practice expense (office) RVU4.61 · 28%
- Malpractice RVU2.38 · 14%
1.7K
Medicare services in 2024 · #2600 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.
27882 compared with similar codes
Office rates for Iowa, from the same CMS release.
No office rate
Code 27881 includes immediate fitting and a rigid dressing. This code describes an open circular amputation instead.
No office rate
Code 27888 describes an amputation at the foot or ankle level; 27882 is for amputation through the tibia and fibula.
No office rate
Code 27889 is for ankle disarticulation. Use 27882 when the documented amputation passes through the tibia and fibula.
Compare 27882 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
Iowa →
Office / nonfacility
Unavailable
Facility
$491.43
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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 27882 in Iowa.
PPRRVU2026_Oct_nonQPP.csv
3,078
- Code
- 27882
- Physician work
- 9.55
- Practice expense
- 4.61
- Malpractice
- 2.38
GPCI2026.csv
53
- Locality
- Iowa
- Physician work
- 1.000
- Practice expense
- 0.915
- Malpractice
- 0.397
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 9.55 | × 1.000 | 9.5500 |
| Practice expense | 4.61 | × 0.915 | 4.2182 |
| Malpractice | 2.38 | × 0.397 | 0.9449 |
| Total RVUs | 14.7130 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Iowa$491.43
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 9.55 | 1 |
| Practice expense | 4.61 | 0.915 |
| Malpractice | 2.38 | 0.397 |
(9.55 × 1 + 4.61 × 0.915 + 2.38 × 0.397) × $33.4009 = $491.43
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.
27882 billing questions
How does this differ from 27880?
This code is for an open circular, or guillotine, lower-leg amputation. Code 27880 describes a lower-leg amputation without that open-technique distinction.
When would 27881 be reported instead?
Use 27881 when the lower-leg amputation includes the immediate fitting technique and application of a rigid dressing. The open circular technique described by this code is distinct.
Can related postoperative care be billed separately?
The 90-day global period includes related postoperative care, as well as the day-before preoperative visit. A later operation to revise or complete the amputation is a separate surgical service, not routine follow-up.
How is bilateral reporting handled?
For bilateral procedures, modifier 50 is paid at 150% under the CMS facts for this code.
What documentation supports assistant or co-surgeon payment?
Assistant-at-surgery payment requires documentation of medical necessity. Co-surgeon payment requires supporting documentation, and team surgery is not permitted.
What happens when another procedure is performed in the same session?
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 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.
3,07527871,,Fusion of tibiofibular joint,A,,9.30,8.22,NA,8.22,,1.85,19.37,19.37,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,07627880,,Amputation of lower leg,A,,14.99,5.97,NA,5.97,,3.67,24.63,24.63,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,07727881,,Amputation of lower leg,A,,13.13,6.41,NA,6.41,,3.18,22.72,22.72,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3,07827882,,Amputation of lower leg,A,,9.55,4.61,NA,4.61,,2.38,16.54,16.54,0,090,0.10,0.69,0.21,2,1,0,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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
5006102,IL,15,SUBURBAN CHICAGO,1.007,1.027,1.772
5106102,IL,99,REST OF ILLINOIS,1.000,0.913,1.563
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915
5607202,LA,01,NEW ORLEANS,1.000,0.941,1.136