CPT® Code 27590

The procedure described by CPT® Code 27590 refers to the surgical amputation of the thigh through the femur at any specified level. This complex surgical intervention involves several critical steps to ensure the safe and effective removal of the leg while preserving as much surrounding tissue as possible for future rehabilitation. Initially, the surgeon marks incision lines on the skin to guide the amputation at the appropriate level. The procedure begins with the incision of the skin and underlying soft tissue, followed by the careful exposure and isolation of muscle groups. During this phase, nerves and blood vessels are meticulously identified and separated to prevent any potential irritation to the nerves from pulsating arteries. The nerves are then transected and allowed to retract into the surrounding soft tissue, while blood vessels are ligated and cut to control bleeding. Once the femur is fully exposed, periosteal flaps are created, and the femur is transected at the level of these flaps. The surgical team then sutures the flaps over the remaining femur to promote healing and protect the underlying structures. To ensure proper muscle function and support, antagonistic muscle groups are sutured together and anchored to the periosteum, effectively enveloping the remaining femur in muscle tissue. Finally, skin flaps are fashioned and sutured over the muscle to complete the procedure. After the amputation, the extremity may be wrapped in an elastic bandage or placed in a plaster splint, as indicated by the use of CPT® Code 27590. Following adequate wound healing, the patient is prepared for fitting with a prosthesis, which is essential for restoring mobility. In cases where a cast of the stump is obtained and the patient is fitted for a prosthesis immediately, CPT® Code 27591 should be utilized instead.