Summary & Overview
CPT 27594: High Femoral Amputation with Secondary Closure
CPT code 27594 denotes a major lower-extremity surgical procedure: amputation of the leg through the femur with secondary closure or scar revision. This code captures high femoral amputations performed for severe trauma, malignant tumors, or aggressive infections that threaten systemic spread. Nationally, accurate coding for major amputations is critical for surgical quality reporting, resource planning, and appropriate reimbursement for high-acuity inpatient surgical care.
Key payers in the national landscape include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of clinical context for the procedure, typical sites of service, and common billing considerations. The publication also summarizes payer coverage patterns, coding benchmarks, and potential documentation elements relevant to claims adjudication.
This analysis is intended to inform hospital billing teams, surgical departments, and health policy stakeholders about the clinical meaning of CPT code 27594, common payer relationships, and the types of measures and documentation that commonly accompany major lower-extremity amputation reporting. Data not available in the input will be identified as such in the detailed sections.
Billing Code Overview
CPT code 27594 describes a surgical amputation of the leg through the femur (high femoral amputation) with secondary closure or scar revision. The procedure involves removal of the lower limb at the thigh level through the femur and includes closure or revision of the residual limb scar.
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Service type: Surgical amputation (major lower extremity amputation)
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Typical site of service: Hospital operating room or inpatient surgical setting
Clinical & Coding Specifications
Clinical Context
A typical patient scenario involves an adult patient with a non-salvageable lower extremity due to severe trauma, progressive limb-threatening infection (such as necrotizing soft tissue infection or uncontrolled osteomyelitis), or malignant tumor of the femur or surrounding soft tissues. The patient presents to the hospital with intractable pain, sepsis risk, nonviable distal limb, or radiographic evidence of an aggressive tumor. The multidisciplinary workflow includes preoperative assessment (history, physical, vascular and oncologic evaluation, imaging such as X-ray/MRI/CT, labs, and discussion of limb salvage versus amputation), informed consent, anesthesia evaluation, and planning of level of amputation. The operative procedure entails transfemoral amputation through the femur at the appropriate level with creation of soft tissue flaps and performance of secondary closure or scar revision as indicated. Postoperative care includes pain control (including regional anesthesia or opioids), wound care, infection surveillance, physical therapy, prosthetic consultation, and discharge planning with outpatient follow-up and prosthetic/rehabilitation coordination. Typical site of service is an inpatient hospital operating room; in select planned cases it may occur in an ambulatory surgery center if medically appropriate, but most cases are inpatient due to complexity and comorbidity. This procedure is commonly performed by orthopedic surgeons or vascular surgeons with assistance from anesthesiology and perioperative teams.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
LT |