Summary & Overview
CPT 27889: Foot Amputation at Ankle (Ankle Disarticulation)
CPT code 27889 represents surgical amputation of the foot by separation at the ankle without incising bone. This procedure is clinically significant nationwide due to its role in limb salvage, management of severe infection, critical limb ischemia, and traumatic injury. It has substantial implications for acute surgical care, post‑operative rehabilitation, prosthetic planning, and long‑term functional outcomes.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Coverage policies and prior authorization practices across these payers influence access to timely surgical intervention and post‑operative services.
Readers will find a concise overview of clinical context, typical sites of service, and common billing considerations related to 27889. The publication summarizes benchmark information where available, highlights relevant policy and coverage themes affecting utilization and reimbursement, and outlines clinical factors that commonly drive use of this procedure. Data not available in the input are identified as such, and the content focuses on national-level implications rather than state-specific guidance.
Billing Code Overview
CPT code 27889 describes surgical amputation of the foot by separation from the lower leg at the ankle without incising bone. The procedure is performed primarily for nonhealing wounds related to infection or poor circulation or to manage traumatic injury.
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Service type: Surgical amputation of the foot at the ankle level
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Typical site of service: Inpatient surgical suite or hospital operating room; may also occur in outpatient surgical centers when clinically appropriate
Clinical & Coding Specifications
Clinical Context
A typical patient is a 68-year-old with diabetes mellitus and peripheral arterial disease who presents with a nonhealing, infected plantar ulcer and progressive ischemic changes of the forefoot despite wound care and revascularization attempts. After multidisciplinary evaluation (vascular surgery, podiatry, infectious disease) and optimization of medical comorbidities, the decision is made to perform a forefoot amputation at the ankle level to control infection and remove nonviable tissue. The patient undergoes preoperative evaluation including vascular imaging, labs, and perioperative antibiotics. The procedure is performed in an operating room under general or regional anesthesia with appropriate tourniquet or hemostatic measures. Postoperative care includes pain control, wound care, infection surveillance, and physical therapy for mobility and prosthetic evaluation when indicated.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
RT | Right side | When the amputation is of the right foot/ankle level |
LT | Left side | When the amputation is of the left foot/ankle level |