© Copyright 2025 American Medical Association. All rights reserved.
The procedure described by CPT® Code 27591 refers to the surgical amputation of the thigh through the femur at any level, utilizing an immediate fitting technique that includes the application of the first cast. This surgical intervention is performed when it is necessary to remove the leg at the femoral level due to various medical conditions, such as severe trauma, malignancy, or vascular disease. The process begins with the careful marking of incision lines on the skin to ensure precision during the amputation. The surgeon then incises the skin and underlying soft tissues, exposing the muscles, which are subsequently isolated and divided by muscle group. Critical structures such as nerves and blood vessels are identified and managed with care to prevent complications, including nerve irritation from pulsatile blood flow. After transecting the nerves and ligating the blood vessels, the femur is exposed, and periosteal flaps are created to facilitate a clean transection of the bone. The remaining femur is then enveloped in muscle, and skin flaps are sutured over the muscle to promote healing. This procedure is distinct in that it allows for the immediate fitting of a prosthesis, which is a crucial aspect of post-operative care, as it aids in the patient's rehabilitation and adjustment to life after amputation.
© Copyright 2025 Coding Ahead. All rights reserved.
The procedure described by CPT® Code 27591 is indicated for patients requiring amputation of the thigh through the femur due to various medical conditions. These may include:
The procedure for CPT® Code 27591 involves several critical steps to ensure a successful amputation and immediate fitting for a prosthesis. The steps are as follows:
After the procedure, the patient will undergo a period of recovery that includes monitoring for any complications such as infection or excessive bleeding. The immediate fitting of a prosthesis is a significant aspect of post-operative care, as it allows the patient to begin the process of rehabilitation and adaptation to their new circumstances. The cast applied during the procedure will help in shaping the stump for the prosthesis, ensuring a better fit and comfort. Patients will be educated on care for the amputation site, including keeping the area clean and dry, and will have follow-up appointments to assess healing and make any necessary adjustments to the prosthesis.
| Short Descr | AMPUTATE LEG AT THIGH | Medium Descr | AMP THI THRU FEMUR LVL IMMT FITG TQ W/1ST CST | Long Descr | Amputation, thigh, through femur, any level; immediate fitting technique including first cast | Status Code | Active Code | Global Days | 090 - Major Surgery | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 2 - Standard payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 1 - 150% payment adjustment for bilateral procedures applies. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 2 - Payment restriction for assistants at surgery does not apply to this procedure... | Co-Surgeons (62) | 1 - Co-surgeons could be paid, though supporting documentation is required... | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Inpatient Procedures, not paid under OPPS | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P3D - Major procedure, orthopedic - other | MUE | 1 | CCS Clinical Classification | 157 - Amputation of lower extremity |
| 22 | Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service. | 50 | Bilateral procedure: unless otherwise identified in the listings, bilateral procedures that are performed at the same session, should be identified by adding modifier 50 to the appropriate 5 digit code. note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 58 | Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78. | 62 | Two surgeons: when 2 surgeons work together as primary surgeons performing distinct part(s) of a procedure, each surgeon should report his/her distinct operative work by adding modifier 62 to the procedure code and any associated add-on code(s) for that procedure as long as both surgeons continue to work together as primary surgeons. each surgeon should report the co-surgery once using the same procedure code. if additional procedure(s) (including add-on procedure(s) are performed during the same surgical session, separate code(s) may also be reported with modifier 62 added. note: if a co-surgeon acts as an assistant in the performance of additional procedure(s), other than those reported with the modifier 62, during the same surgical session, those services may be reported using separate procedure code(s) with modifier 80 or modifier 82 added, as appropriate. | 78 | Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.) | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). | GC | This service has been performed in part by a resident under the direction of a teaching physician | LT | Left side (used to identify procedures performed on the left side of the body) | RT | Right side (used to identify procedures performed on the right side of the body) |
|
Date
|
Action
|
Notes
|
|---|---|---|
| Pre-1990 | Added | Code added. |
Get instant expert-level medical coding assistance.