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CPT 27598: Lower Leg Disarticulation Preserving Femoral End

CPT code 27598 denotes a surgical lower-extremity disarticulation in which the tibia and fibula are separated from the femur without bone cutting, enabling removal of the lower leg while preserving the distal femoral end for partial weight bearing. This procedure has clinical importance for limb salvage decisions, prosthetic planning, and postoperative rehabilitation, and it has cost and coverage implications across national payer markets. Key payers considered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical description, the typical settings where the service is delivered, commonly reported billing modifiers, and an overview of payer coverage considerations and benchmarking where available. The publication outlines how CPT code 27598 is used in clinical documentation, the procedural context for orthopedic and vascular surgical teams, and operational factors affecting hospital and ambulatory surgical center billing. Data not available in the input is noted where benchmarks, associated taxonomies, and specific ICD-10 mappings would otherwise be discussed.

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Billing Code Overview

CPT code 27598 describes a surgical procedure to separate the tibia and fibula of the lower leg from the femur without cutting bones, allowing removal of the lower leg while preserving the femoral end so the patient can bear some weight on the residual limb. This procedure is a form of lower extremity amputation performed at the level of the distal femur.

Service type: Surgical amputation of the lower leg with preservation of femoral bone end (closed disarticulation/through-knee–type approach)
Typical site of service: Operating room or surgical suite in an acute care hospital or ambulatory surgical center where major limb amputation procedures are performed

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CPT 27598: Lower Leg Disarticulation Preserving Femoral End

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Billing Code Overview

Service type: Surgical amputation of the lower leg with preservation of femoral bone end (closed disarticulation/through-knee–type approach)
Typical site of service: Operating room or surgical suite in an acute care hospital or ambulatory surgical center where major limb amputation procedures are performed

Clinical & Coding Specifications

Clinical Context

A typical patient is an adult with a non-salvageable lower leg after severe trauma (e.g., mangling crush injury, ischemic necrosis, or severe infection) or chronic limb-threatening conditions where limb preservation is not possible. The patient presents with uncontrolled pain, nonviable distal tissue, or prosthetic and functional considerations favoring an above-knee amputation that spares cutting the femur.

Preoperative workflow includes multidisciplinary evaluation (trauma or vascular surgery, orthopedics, anesthesia, rehabilitation and prosthetics consultation), informed consent discussing weight-bearing and prosthetic outcomes, preoperative imaging as needed, and optimization of comorbidities. In the operating room under general or regional anesthesia, the surgeon performs a knee disarticulation (surgical separation of the tibia and fibula from the femur) preserving the femoral length and soft tissue envelope to allow partial weight bearing on the femoral condyles. Postoperative care includes pain control, wound monitoring, early mobilization, physical therapy, and coordination with prosthetics and home health as indicated.

Coding Specifications

Modifier	Description	When to Use
`LT`	Left side	When the procedure is performed on the left leg.
`RT`	Right side	When the procedure is performed on the right leg.
`50`	Bilateral procedure	When knee disarticulation is performed bilaterally during the same operative session.
`62`	Two surgeons	When two surgeons work together as primary surgeons for distinct portions of the procedure.
`66`	Surgical team	When a surgical team reports global care for a complex procedure.
`52`	Reduced services	When the procedure is partially reduced or not completed as planned.
`53`	Discontinued procedure	When the procedure is started but terminated due to extenuating circumstances.
`22`	Increased procedural services	When work or complexity substantially exceeds typical requirements.
`78`	Unplanned return to OR	When patient returns to the operating room for a related procedure during the postoperative period.
`79`	Unrelated procedure or service during postoperative period	For an unrelated procedure performed during the global period.
`55`	Postoperative management only	When only postoperative care is provided by the reporting surgeon.
`23`	Unusual anesthesia	When general anesthesia is not used and the procedure required an unusual anesthetic circumstance.
`26`	Professional component	If reporting separate professional component with a distinct billing arrangement (rare for this surgical CPT).
`AS`	Ambulatory surgery center facility	When the service is provided at an ambulatory surgery center setting.
`53`	Discontinued procedure	When the operation is terminated prior to completion for patient safety (note: listed again to emphasize clinical relevance).

Taxonomy Code	Specialty	Notes
2080P0202X	Orthopaedic Surgery	Orthopedic surgeons commonly perform knee disarticulation for traumatic or oncologic indications.
208000000X	General Surgery	General surgeons may perform disarticulation in trauma or vascular surgery contexts.
207L00000X	Vascular Surgery	Vascular surgeons perform amputations for ischemic or vascular limb loss.
2084P0800X	Trauma Surgery	Trauma surgeons manage emergent limb-threatening injuries requiring disarticulation.
225100000X	Physical Medicine & Rehabilitation	PM&R physicians coordinate postoperative rehabilitation and prosthetic planning.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`S78.101A`	Traumatic amputation of lower leg, incomplete, right lower leg, initial encounter	Severe traumatic injury that may lead to knee disarticulation if limb is non-salvageable.
`S78.102A`	Traumatic amputation of lower leg, incomplete, left lower leg, initial encounter	Same relevance for left-sided traumatic injuries.
`T79.8XXA`	Other late effects of injury, initial encounter	Complications from prior injuries leading to delayed decision for disarticulation.
`I70.239`	Atherosclerosis of native arteries of extremities with rest pain, right leg	Ischemic limb with rest pain that may progress to nonviable tissue requiring disarticulation.
`I70.238`	Atherosclerosis of native arteries of extremities with rest pain, left leg	Same relevance for left leg ischemia.
`L08.9`	Local infection of the skin and subcutaneous tissue, unspecified	Severe infection or necrotizing soft tissue infection may necessitate knee disarticulation.
`C49.9`	Soft tissue sarcoma, unspecified site	Oncologic indications where limb-sparing is not possible and disarticulation is required.
`Z89.612`	Acquired absence of leg above knee, right	Postoperative status code used in longitudinal records after knee disarticulation.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`27880`	Revision of amputation stump, thigh or leg; without skeletal revision	May be performed later if stump complications or need for revision after knee disarticulation.
`28800`	Application of external fixation system, knee and leg; initial placement	May be used prior to definitive amputation in complex trauma to stabilize limb.
`11042`	Debridement; subcutaneous tissue, first 20 sq cm or less	Preoperative or staged debridement of infected or necrotic tissue before definitive disarticulation.
`20670`	Removal of implant; deep (e.g., buried pins, rods)	Removal of prior hardware that may complicate amputation.
`99281`	Emergency department visit, problem-focused	Typical initial ED evaluation code when patient presents with acute limb-threatening injury leading to eventual disarticulation.
`97530`	Therapeutic activities, direct (one-on-one) patient contact	Postoperative rehabilitation therapy commonly provided during recovery and prosthetic training.

Related Codes

CPT-27590-FEMORAL-AMPUTATION-ABOVE-KNEE

CPT 27590: Femoral (Above-Knee) Leg Amputation

CPT-27591-TRANSFEMORAL-AMPUTATION-IMMEDIATE-PROSTHESIS

CPT 27591: Transfemoral Amputation with Immediate Prosthesis Fitting

CPT-27592-FEMORAL-TRANSSECTION-FOR-INFECTION-CONTROL

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-27596-FEMORAL-STUMP-SHORTENING-AMPUTATION-REVISION

CPT 27596: Femoral Stump Shortening for Prosthetic Fitting

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Jul 29, 2026.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.

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Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Modifier	Description	When to Use
`LT`	Left side	When the procedure is performed on the left leg.
`RT`	Right side	When the procedure is performed on the right leg.
`50`	Bilateral procedure	When knee disarticulation is performed bilaterally during the same operative session.
`62`	Two surgeons	When two surgeons work together as primary surgeons for distinct portions of the procedure.
`66`	Surgical team	When a surgical team reports global care for a complex procedure.
`52`	Reduced services	When the procedure is partially reduced or not completed as planned.
`53`	Discontinued procedure	When the procedure is started but terminated due to extenuating circumstances.
`22`	Increased procedural services	When work or complexity substantially exceeds typical requirements.
`78`	Unplanned return to OR	When patient returns to the operating room for a related procedure during the postoperative period.
`79`	Unrelated procedure or service during postoperative period	For an unrelated procedure performed during the global period.
`55`	Postoperative management only	When only postoperative care is provided by the reporting surgeon.
`23`	Unusual anesthesia	When general anesthesia is not used and the procedure required an unusual anesthetic circumstance.
`26`	Professional component	If reporting separate professional component with a distinct billing arrangement (rare for this surgical CPT).
`AS`	Ambulatory surgery center facility	When the service is provided at an ambulatory surgery center setting.
`53`	Discontinued procedure	When the operation is terminated prior to completion for patient safety (note: listed again to emphasize clinical relevance).

Taxonomy Code	Specialty	Notes
2080P0202X	Orthopaedic Surgery	Orthopedic surgeons commonly perform knee disarticulation for traumatic or oncologic indications.
208000000X	General Surgery	General surgeons may perform disarticulation in trauma or vascular surgery contexts.
207L00000X	Vascular Surgery	Vascular surgeons perform amputations for ischemic or vascular limb loss.
2084P0800X	Trauma Surgery	Trauma surgeons manage emergent limb-threatening injuries requiring disarticulation.
225100000X	Physical Medicine & Rehabilitation	PM&R physicians coordinate postoperative rehabilitation and prosthetic planning.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`S78.101A`	Traumatic amputation of lower leg, incomplete, right lower leg, initial encounter	Severe traumatic injury that may lead to knee disarticulation if limb is non-salvageable.
`S78.102A`	Traumatic amputation of lower leg, incomplete, left lower leg, initial encounter	Same relevance for left-sided traumatic injuries.
`T79.8XXA`	Other late effects of injury, initial encounter	Complications from prior injuries leading to delayed decision for disarticulation.
`I70.239`	Atherosclerosis of native arteries of extremities with rest pain, right leg	Ischemic limb with rest pain that may progress to nonviable tissue requiring disarticulation.
`I70.238`	Atherosclerosis of native arteries of extremities with rest pain, left leg	Same relevance for left leg ischemia.
`L08.9`	Local infection of the skin and subcutaneous tissue, unspecified	Severe infection or necrotizing soft tissue infection may necessitate knee disarticulation.
`C49.9`	Soft tissue sarcoma, unspecified site	Oncologic indications where limb-sparing is not possible and disarticulation is required.
`Z89.612`	Acquired absence of leg above knee, right	Postoperative status code used in longitudinal records after knee disarticulation.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`27880`	Revision of amputation stump, thigh or leg; without skeletal revision	May be performed later if stump complications or need for revision after knee disarticulation.
`28800`	Application of external fixation system, knee and leg; initial placement	May be used prior to definitive amputation in complex trauma to stabilize limb.
`11042`	Debridement; subcutaneous tissue, first 20 sq cm or less	Preoperative or staged debridement of infected or necrotic tissue before definitive disarticulation.
`20670`	Removal of implant; deep (e.g., buried pins, rods)	Removal of prior hardware that may complicate amputation.
`99281`	Emergency department visit, problem-focused	Typical initial ED evaluation code when patient presents with acute limb-threatening injury leading to eventual disarticulation.
`97530`	Therapeutic activities, direct (one-on-one) patient contact	Postoperative rehabilitation therapy commonly provided during recovery and prosthetic training.

Related Codes

CPT-27590-FEMORAL-AMPUTATION-ABOVE-KNEE

CPT 27590: Femoral (Above-Knee) Leg Amputation

CPT-27591-TRANSFEMORAL-AMPUTATION-IMMEDIATE-PROSTHESIS

CPT 27591: Transfemoral Amputation with Immediate Prosthesis Fitting

CPT-27592-FEMORAL-TRANSSECTION-FOR-INFECTION-CONTROL

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-27596-FEMORAL-STUMP-SHORTENING-AMPUTATION-REVISION

CPT 27596: Femoral Stump Shortening for Prosthetic Fitting

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Jul 29, 2026.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.

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CPT 27598: Lower Leg Disarticulation Preserving Femoral End

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Billing Code Overview

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CPT 27598: Lower Leg Disarticulation Preserving Femoral End

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Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References

CPT 27598: Lower Leg Disarticulation Preserving Femoral End

Sign up for cpt 27598 policy alerts

Billing Code Overview

CPT 27598: Lower Leg Disarticulation Preserving Femoral End

Sign up for cpt 27598 policy alerts

Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

What specifically does CPT 27598 represent and in what clinical situations is it typically used?

Which billing modifiers are commonly used with CPT 27598?

Which specialties commonly perform or manage care related to this procedure?

What related CPT codes should I consider when billing perioperative or follow-up services?

Which payers are included in the coverage considerations for CPT 27598 and are reimbursement rates provided?

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

What specifically does CPT 27598 represent and in what clinical situations is it typically used?

Which billing modifiers are commonly used with CPT 27598?

Which specialties commonly perform or manage care related to this procedure?

What related CPT codes should I consider when billing perioperative or follow-up services?

Which payers are included in the coverage considerations for CPT 27598 and are reimbursement rates provided?

References