Billing code 27889: Ankle amputationMedicare rate & RVUs in Washington
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.
CMS doesn’t publish an office rate for 27889 in Washington.
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 27889 covers
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.
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 27889 pays more and less in Washington
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Washington | Unavailable | $592.63 |
| Seattle (King Cnty) | Unavailable | $639.08 |
How the 27889 rate is calculated
Each of 27889’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 · 27889
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 10.59Practice expense 5.00Malpractice 2.30
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 27889
27889 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 27889
Ankle 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) | 1 | Not paid (statutory restriction). |
| 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 · 27889
Ankle 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
27889 without 50 · national facility
$597.54
Ankle amputation
27889-50 · Bilateral: 150%
$896.31
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).
27889 compared with similar codes
Compare codes
27889 vs 27888 vs 27880 vs 27884: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 27888Foot amputation
- 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.
- 27880Leg amputation
- 27880 is for an amputation through the tibia and fibula, above the ankle; 27889 is the ankle-level disarticulation.
- 27884Stump revision
- 27884 describes revision of a below-knee amputation, not the initial ankle disarticulation reported with 27889.
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 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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