CPT® Code 27591

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.