Summary & Overview
CPT 27590: Femoral (Above-Knee) Leg Amputation
CPT code 27590 denotes complete removal of the leg at any point on the femur with closure of the remaining muscle and skin layers — commonly described as an above-knee or femoral-level amputation. This code captures a high-acuity, major surgical procedure with significant clinical, functional, and cost implications nationwide. It is relevant to surgical services, inpatient care, rehabilitation planning, prosthetic provision, and long-term disability considerations.
Key payers included in the national perspective are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical context for the procedure, an outline of typical sites of service and service type, and guidance on what to expect in payer coverage analyses. The publication covers common claim modifiers associated with major surgical procedures (provided in source data), benchmarking considerations, and operational implications for hospitals and surgical practices.
This overview helps clinicians, coding staff, and revenue-cycle professionals identify where CPT code 27590 fits in surgical service lines, anticipate inpatient resource use, and align documentation with coding requirements. Data not available in the input is noted where applicable; the focus remains on national relevance rather than state-specific policy.
Billing Code Overview
CPT code 27590 describes surgical removal of the leg at any point on the femur, with closure of the remaining muscle and skin layers. This is an amputation at the femoral level (above-knee amputation).
Service Type: Surgical amputation (major limb amputation)
Typical Site of Service: Inpatient operating room or surgical suite, with subsequent inpatient postoperative care and wound management.
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult with a nonviable, severely damaged, or infected lower extremity requiring removal at the level of the femur (transfemoral amputation). The clinical workflow begins with preoperative evaluation by an orthopedic or vascular surgeon, including history, vascular studies, infection control, optimization of comorbidities (for example diabetes mellitus and peripheral arterial disease), and informed consent. On the day of surgery the patient is admitted to an operating room or surgical suite; regional or general anesthesia is administered; the surgeon performs a complete amputation of the leg through the femur, achieves hemostasis, contours remaining muscle and soft tissue to form a functional residual limb, and closes the wound in layers. Postoperative care includes pain control, wound and stump care, physical therapy and prosthetic consultation, and coordination of home health or inpatient rehabilitation as needed. Typical site of service is an inpatient hospital operating room or ambulatory surgical center depending on patient acuity and comorbidities. Common clinical indications include critical limb ischemia with gangrene, severe traumatic injury to the femur/leg, uncontrolled osteomyelitis, or malignant tumors involving the lower limb.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
50 | Bilateral procedure | Used when bilateral lower limb amputations are performed during the same operative session. |