Amputation Limits by State, From Toes to the Whole Foot

For a wound-care or limb-salvage podiatrist, amputation scope decides which cases stay in your hands and which go to a vascular or orthopedic colleague. It also varies more than almost anything else in podiatric law. The statutes below draw the line at the toes, at the transmetatarsal level, at Chopart's joint, at the ankle or nowhere at all. None of these limits travels with you: the state where the patient is treated sets the line.

Where is amputation off the table entirely?

• Massachusetts excludes "amputation of the foot or toes" from podiatry (M.G.L. c. 112, section 13). It is the only state read here that bars toe amputation outright.
• Texas makes it a criminal offense for a podiatrist to amputate a human foot, punishable by a fine of $100 to $500, 30 days to six months in county jail, or both (Tex. Occ. Code 202.606).

Which states bar foot amputation but allow toes or part of the foot?

• Kansas: surgery "including amputation of the toes or part of the foot," but "no podiatrist shall amputate the human foot" (K.S.A. 65-2002(b)).
• Florida: "the amputation of the toes or other parts of the foot but shall not include the amputation of the foot or leg in its entirety" (Fla. Stat. 461.003). Wyoming uses almost the same words (W.S. 33-9-101).
• Arizona: podiatry excludes "amputating the leg or entire foot" (A.R.S. 32-801).
• Washington: podiatrists "shall not amputate the foot" (RCW 18.22.035).
• Colorado: amputation of the foot is excluded (C.R.S. 12-290-102).
• Iowa: "A license to practice podiatry shall not authorize the licensee to amputate the human foot" (Iowa Code 149.5).
• Missouri: amputation of the foot is excluded from podiatry (RSMo 330.010).
• Oregon: podiatry "does not include ... the amputation of the entire foot" (ORS 677.010).
• Minnesota: treatment "includes partial foot amputation" and excludes amputation of the hand or fingers (Minn. Stat. 153.01).

Where do the statutes name an anatomic level?

Several states draw a specific line, which matters for transmetatarsal and Chopart procedures:

• California: "a partial amputation of the foot no further proximal than the Chopart's joint" (Cal. Bus. & Prof. Code 2472(d)).
• Alabama: amputation of the toes and other parts of the foot and ankle, "but shall not include any amputation above the Chopart joint" (Ala. Code 34-24-230(9)).
• Connecticut: Chopart joint-level amputation is part of the "surgical treatment of the ankle" available to podiatrists who filed the ankle documentation with the Department of Public Health (C.G.S. 20-54(c)).
• Virginia: podiatry "does not include amputation of the foot proximal to the transmetatarsal level through the metatarsal shafts," and amputations proximal to the metatarsal-phalangeal joints may be performed only in an accredited hospital or ambulatory surgery facility (Va. Code 54.1-2900).
• South Carolina: podiatry excludes "the amputation of the entire foot," and podiatric ankle surgery excludes "amputation of the leg or foot above the level of the transmetatarsal" (S.C. Code 40-51-20).
• Michigan: podiatric medicine and surgery "does not include amputations proximal to the tibiotalar joint" (MCL 333.18001).
• Hawaii: podiatry "does not include amputation above the ankle" (HRS 463E-1).
• Nebraska: the practice of podiatry excludes "the amputation of the forefoot" (Neb. Rev. Stat. 38-3005). Read that one closely before planning any forefoot procedure there.

Which states tie amputation to a facility or a privilege?

• Nevada allows a podiatric physician to amputate a toe only in a hospital or ambulatory surgical center that authorizes it, after a surgical residency, and never a leg or foot (NRS 635.085).
• North Carolina excludes amputation of the entire foot and requires any amputation to be done in a hospital or a multispecialty ambulatory surgical facility where the podiatrist holds privileges (G.S. 90-202.2). The board grants a surgical specialty privilege in amputation on application with surgery logs (21 NCAC 52 .0212).
• Vermont requires "amputations other than toe amputations" to be done in a licensed general hospital or certified ambulatory surgical center (26 V.S.A. 321).
• Delaware restricts foot amputation to podiatrists with an accredited surgical residency and current amputation privileges, or who meet the hospital surgical committee's credentialing criteria (24 Del. C. 502).

Which state allows amputation of the whole foot?

North Dakota's definition of podiatric medicine includes "the amputation of the toes, parts of the foot, or foot in its entirety, indicated as medically necessary" (N.D.C.C. 43-05-01). Of the statutes read for this guide, it is the only one that reaches the whole foot.

What does a North Carolina amputation privilege application ask for?

North Carolina is the one state read here where the podiatry board itself grants an amputation credential. Its rule asks for the application form and two copies of your surgery logs, highlighted by specialty area (amputations, ankle surgery, clubfoot correction), along with your post-graduate training by years, type and location, board certifications and years, any Fellow status in the American College of Foot and Ankle Surgeons, other postgraduate CME, hospital and surgery center affiliations with privileges and dates, teaching appointments, and the privileges you are applying for (21 NCAC 52 .0212). The case logs are the heavy part: keep them in a form that can be filtered by procedure and date.

How do amputation limits interact with ankle credentials?

In Connecticut the two are linked. Chopart joint-level amputation is listed as part of "surgical treatment of the ankle," which a podiatrist may perform independently only after documenting, for graduates on or after June 1, 2006, a three-year CPME-accredited residency and current ABFAS certification or qualification in reconstructive rearfoot ankle surgery (C.G.S. 20-54(c)). A Connecticut podiatrist without that documentation on file should not assume Chopart-level procedures are available. In California, by contrast, the Chopart limit sits in the base license, separate from the hospital-privilege rule for ankle surgery (Cal. Bus. & Prof. Code 2472(d), (e)).

What should you ask a facility before a limb-salvage case in a new state?

1. Does the state statute allow this level of amputation for a podiatrist at all?
2. Does the statute require a hospital or ASC, or a facility authorization, for it (Nevada, North Carolina, Vermont, Virginia, Delaware)?
3. Does the facility's own delineation of privileges list the procedure for podiatrists?
4. Is any anesthesia beyond local needed, and who provides it? See anesthesia limits by state.

Why does this matter when you change states?

A podiatrist who performs transmetatarsal amputations in Virginia, inside a hospital, is within scope. The same procedure is outside podiatry in Massachusetts. Kansas allows part of the foot but never the whole foot, and in Texas a foot amputation is a crime. A partial foot procedure at the Chopart level is allowed in California and Alabama, available in Connecticut only after ankle documentation is on file, and too proximal in Virginia and South Carolina.

That is why a scope check should happen before a wound-care company assigns a podiatrist to a new state, not after the first referral. Our checklist for wound-care companies walks through it, and the leg-wound side is covered in how far up the leg a podiatrist can treat wounds.

Are there states not listed here?

Yes. Some practice acts read for this site say nothing explicit about amputation, and others are still being confirmed. The scope by state table marks each state as verified or being confirmed. Where a statute is silent, ask the board and your facility's credentials committee before planning the case, and keep the answer in writing with your privileging file. A silent statute is not a grant, and an amputation that a hospital is willing to privilege can still be outside what the state allows a podiatrist to do.

How can we help?

A Podiatry Licensure Readiness Review ($149) includes a scope check, amputation and anesthesia included, for every state on your list. If you decide to license, we prepare the application, and where a state like North Carolina has a separate specialty privilege, the Ankle & Scope Credential Add-On ($499 per state) assembles the surgery logs and training records. You sign the application, and the board decides.