Summary & Overview
CPT 27591: Transfemoral Amputation with Immediate Prosthesis Fitting
CPT code 27591 denotes a transfemoral (above-knee) amputation with immediate prosthesis fitting. This code captures definitive surgical removal of the leg at the femur with wound closure and immediate prosthetic placement intended to accelerate early mobilization and functional recovery. Nationally, accurate coding for high-acuity surgical procedures like 27591 is essential for appropriate episode classification, resource allocation, and tracking of surgical quality and rehabilitation outcomes.
Key payers commonly involved in coverage and payment discussions for this service include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find concise information about clinical context, expected site-of-service patterns, and typical service line classification. The report outlines benchmarks used by major payers, recent policy updates affecting perioperative and prosthetic coverage, and clinical considerations tied to early prosthetic fitting. Practical elements include coding scope, expected care settings, and implications for inpatient surgical and acute rehabilitation billing.
This summary is written for a national audience and is intended to orient clinicians, coding professionals, and payers to the clinical purpose and billing context of CPT code 27591 without state-specific detail. Data not provided in the input, such as specific payer fee schedules, ICD-10 pairings, and taxonomies, are omitted.
Billing Code Overview
CPT code 27591 reports a transfemoral (above-knee) amputation with immediate prosthesis fitting. The procedure involves complete removal of the leg at any point on the femur, followed by closure of remaining muscle and skin layers and placement of an immediate prosthetic device to promote early mobilization and restoration of physical function.
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Service type: Surgical amputation with immediate prosthetic fitting
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Typical site of service: Inpatient surgical suite or operating room with postoperative inpatient or acute rehabilitative care
Clinical & Coding Specifications
Clinical Context
A typical patient is a middle-aged or older adult who presents with a nonviable or severely compromised lower extremity at or proximal to the femur due to trauma, ischemia, infection, malignancy, or failed limb salvage. The clinical workflow begins with emergency or scheduled preoperative evaluation including history, physical exam, vascular and infection assessment, imaging (X-ray, CT, or MRI as indicated), and laboratory testing. Multidisciplinary planning involves orthopedic or vascular surgeons, anesthesiology, rehabilitation medicine, and prosthetics. The procedure 27591 describes a transfemoral (above-knee) amputation with complete removal of the leg at any level of the femur and immediate fitting of a temporary or definitive prosthesis to facilitate early mobilization. Intraoperative steps include femoral osteotomy, soft tissue and muscle flap formation, meticulous hemostasis, and layered closure. Postoperative care includes pain control, stump care and protection, early physical therapy and gait training with the immediate prosthetic fit, wound surveillance, and coordinated discharge planning with outpatient prosthetics and rehabilitation services. Typical sites of service are the hospital operating room for inpatient or same-day surgery and specialized surgical centers equipped for major amputations. Expected clinical indications include ischemic limb with gangrene, severe crush or traumatic limb loss, refractory osteomyelitis, or locally advanced malignancy involving the femur or soft tissues where limb preservation is not possible.
Coding Specifications
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