Billing code 25927: Hand amputationMedicare rate & RVUs in Texas
Reports surgical removal of the hand through the metacarpal level, typically when injury, infection, or disease makes preservation of the hand impossible.
CMS doesn’t publish an office rate for 25927 in Texas.
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 25927 covers
This operation removes the hand through the metacarpal level while preserving the wrist. It may be performed for a severely mangled hand, nonviable tissue after trauma, or disease that cannot be controlled while retaining the hand. An orthopedic or hand surgeon, plastic surgeon, or other qualified surgeon typically performs the procedure in a hospital or ambulatory surgical setting. The operative report should identify the amputation level and describe the procedure performed.
Report 25927 when the documented operative level is through the metacarpals, not at the wrist or through the forearm. This major surgery has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. If multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment requires documented medical necessity; co-surgeon and team-surgery claims are 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 25927 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | Unavailable | $861.27 |
| Beaumont | Unavailable | $792.27 |
| Brazoria | Unavailable | $824.11 |
| Dallas | Unavailable | $831.76 |
| Fort Worth | Unavailable | $827.78 |
| Galveston | Unavailable | $828.12 |
| Houston | Unavailable | $862.90 |
| Rest Of Texas | Unavailable | $809.36 |
How the 25927 rate is calculated
Each of 25927’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 · 25927
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 8.86Practice expense 14.39Malpractice 1.90
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 25927
25927 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 25927
Hand 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) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| 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 · 25927
Hand 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
25927 without 50 · national facility
$840.03
Hand amputation
25927-50 · Bilateral: 150%
$1,260.05
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).
25927 compared with similar codes
Compare codes
25927 vs 25920 vs 25922 vs 25900: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 25920Hand amputation
- 25920 describes a wrist-level hand amputation. Use 25927 when the operative level is through the metacarpals.
- 25922Hand amputation
- 25922 is also for a wrist-level hand amputation. The operative report's stated level determines whether 25927 is appropriate.
- 25900Forearm amputation
- 25900 is a forearm amputation, a more proximal level than the metacarpal-level hand amputation reported with 25927.
25927 billing questions
How do I distinguish 25927 from a wrist-level hand amputation?
Use 25927 when the operative level is through the metacarpals. Codes 25920 and 25922 describe wrist-level hand amputations.
What documentation supports 25927?
The operative report should establish the precise amputation level through the metacarpals and describe the procedure performed. The clinical record should support the need for removal of the hand.
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 25927 reported?
Report modifier 50 for a bilateral procedure; CMS pays the bilateral service at 150%.
Can an assistant surgeon be reported?
Assistant-at-surgery payment is available only when medical necessity is documented. Co-surgeon and team-surgery claims are not permitted for this procedure.
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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