CPT 27596 Femoral Stump Shortening Reimbursement | OpenPayer

Summary & Overview

CPT 27596: Femoral Stump Shortening for Prosthetic Fitting

CPT code 27596 covers surgical shortening or revision of an already amputated femur when the residual stump is nonhealing or unsuited for prosthetic fitting. The procedure is clinically significant because stump integrity and length directly affect wound healing, prosthetic fitting, mobility outcomes, and prosthesis candidacy. Nationally, appropriate coding for femoral stump revisions affects surgical quality reporting, payment determinations, and continuity of care for amputation patients. Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of what CPT code 27596 represents, the typical clinical context and sites of service, and the primary payer landscape. The publication outlines common billing modifiers associated with complex surgical services, summarizes where to expect coverage considerations, and highlights clinical factors that drive use of this code, including nonhealing stumps and prosthetic fitting needs. It also explains what information is not available in the input and points readers to where to look for payer-specific reimbursement policies. This national-level summary is intended to inform coding accuracy, administrative planning, and clinical documentation for surgical teams and billing staff involved in lower-extremity amputation care.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare27596CPTamputation-revisionfemoral-stumporthopedic-surgeryprosthetic-fittingsurgical-coding

Billing Code Overview

CPT code 27596 describes a surgical procedure to remove additional length from an already amputated femur (thigh) bone. This is performed when a residual femoral stump is nonhealing or is not appropriate in its current form to fit a prosthesis.

Service type: Surgical amputation revision (femoral stump shortening)
Typical site of service: Inpatient or outpatient surgical setting, depending on clinical needs and anesthesia requirements

Data not available in the input.

Clinical & Coding Specifications

Clinical Context

A 62-year-old male with a transfemoral (above-knee) amputation from prior traumatic injury presents to the orthopedic surgery clinic with persistent stump pain, wound drainage, and failure of the distal femoral residual limb to heal or to allow prosthetic fitting. Conservative measures including wound care and antibiotics have failed. The surgical team plans a revision amputation to shorten the femoral residual limb to healthy tissue, reshape the bone and soft tissues, and create a stump suitable for prosthetic fitting and pain control. The procedure is performed in an operating room under general or regional anesthesia with perioperative antibiotics. Typical workflow includes preoperative evaluation and imaging (plain radiographs of the residual femur), intraoperative removal of scar tissue and nonviable bone, femoral shortening and soft-tissue revision, hemostasis, layered closure, and postoperative dressing and prosthetic consultation. Usual sites of service are the hospital operating room or an ambulatory surgical center depending on patient comorbidities and complexity. Postoperative care includes pain management, stump care instructions, wound checks, and coordination with prosthetics and rehabilitation services for eventual prosthesis fitting.

Coding Specifications

Modifier	Description	When to Use
`LT` / `RT`	Left or Right side designator	Use to identify the side of the amputation when laterality applies to documentation and billing.

CPT 27592: Complete Femoral Transection to Control Limb Infection

CPT-27594-HIGH-FEMORAL-AMPUTATION-SECONDARY-CLOSURE

CPT 27594: High Femoral Amputation with Secondary Closure

CPT-27598-LOWER-LEG-DISARTICULATION-PRESERVING-FEMORAL-END

CPT 27598: Lower Leg Disarticulation Preserving Femoral End

CPT-27591-TRANSFEMORAL-AMPUTATION-IMMEDIATE-PROSTHESIS

CPT 27591: Transfemoral Amputation with Immediate Prosthesis Fitting

CPT-27590-FEMORAL-AMPUTATION-ABOVE-KNEE

CPT 27590: Femoral (Above-Knee) Leg Amputation

Taxonomy Code	Specialty	Notes
208600000X	Orthopedic Surgery	Primary specialty performing femoral stump revision and amputation-related surgeries.
207L00000X	General Surgery	May perform amputations and stump revisions in some settings.
2080P0207X	Physical Medicine & Rehabilitation	Involved in postoperative rehabilitation and prosthetic coordination.
2084P0800X	Prosthetics & Orthotics	Provides prosthetic fitting and device planning following stump revision.
207X00000X	Vascular Surgery	Involved when vascular insufficiency or revascularization is a contributing factor to nonhealing stump.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`M86.171`	Acute osteomyelitis, femur, right	Osteomyelitis of the residual femur can necessitate bone resection and stump revision.
`M86.172`	Acute osteomyelitis, femur, left	Same relevance for left-sided residual limb infection.
`T87.31`	Nontraumatic amputation stump infection, right lower leg	Stump infection is a common indication for revision amputation and additional bone removal.
`T87.32`	Nontraumatic amputation stump infection, left lower leg	Same for left side.
`L89.153`	Pressure ulcer of thigh, stage 3, right	Chronic pressure ulcers over a residual limb can lead to nonhealing wounds requiring stump revision.
`L89.154`	Pressure ulcer of thigh, stage 3, left	Same for left side.
`Z89.611`	Acquired absence of right leg above knee	Relevant for history coding of prior amputation when documenting revision procedures.
`Z89.612`	Acquired absence of left leg above knee	Same for left side.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`27596`	Surgery, amputation, thigh; revision of stump, additional bone removed from already amputated femur	Primary procedure: femoral stump shortening or revision to address nonhealing or facilitate prosthesis fitting.
`11042`	Debridement; skin, subcutaneous tissue and muscle, first 20 sq cm or less	May be used when extensive debridement of nonviable soft tissue is performed in conjunction with stump revision.
`11043`	Debridement; includes bone (if performed)	Use when debridement extends to bone and necrotic bone is removed prior to or during stump revision.
`27590`	Amputation, thigh, through femur (primary amputation)	Related primary amputation code for initial amputations; relevant in patient history and prior operative reports.
`20610`	Arthrocentesis, aspiration and/or injection; major joint or bursa	May be used for diagnostic or therapeutic injections in adjacent joints during preoperative management of residual limb pain.
`99024`	Postoperative follow-up visit global, after surgery	Used to report distinct postoperative visits during the global period when appropriate according to payer rules.

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