CPT 20527 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
| Key Fact | Detail |
|---|---|
| Service Type | • Surgery • Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | • 11 - Office • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • RT - Right side of body • LT - Left side of body |
| Complexity Level | Low |
National average reimbursement for CPT 20527 by major payers:
$117.12
$113.41
$117.15
$154.66
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 20527 | ||||||
United | 20527 | $145.35 | 1295014348 - MANUEL DIAZ | 350593390 - DEACONESS HOSPITAL INC | FL | Internal Medicine Physician (207R00000X) |
United | 20527 | $566.00 | 1053574244 - SURGERY CENTER AT UNIVERSITY PARK, LLC, PREMIER SURGERY CENTER OF SARASOTA | 203757623 - (FL) SURGERY CENTER AT UNIVERSITY PARK LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20527 | $312.00 | 1538336219 - PACIFIC CATARACT AND LASER INSTITUTE INC PC | 911394965 - PACIFIC CATARACT AND LASER INSTITUTE, INC., PC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20527 | $1327.00 | 1164732426 - NORWALK SURGERY CENTER, LLC | 272394942 - (CT) NORWALK SURGERY CENTER LLC | CT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20527 | $574.00 | 1326453325 - CAPITAL CITY SURGERY CENTER OF FLORIDA LLC | 471211202 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20527 | $86.00 | 1649317660 - ORTHOVIRGINIA, INC | 540885859 - (VA) ORTHOVIRGINIA, INC. | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20527 | $234.00 | 1629142666 - ENDOSCOPY CENTER OF BUCKS COUNTY, LP | 841693856 - (PA) ENDOSCOPY CENTER OF BUCKS COUNTY LP | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20527 | $578.00 | 1255797726 - BLOOMFIELD ASC LLC | 474758895 - (CT) BLOOMFIELD ASC, LLC | CT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20527 | $237.00 | 1649252883 - FOUNDATION SURGERY AFFILIATE OF NACOGDOCHES LLC, NACOGDOCHES SURGERY CENTER | 731589339 - (TX) FOUNDATION SURGERY AFFILIATE OF NACOGDOCHES LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20527 | $98.00 | 1336213099 - SAN GABRIEL AMBULATORY SURGERY CENTER, LP | 510470714 - (CA) SAN GABRIEL AMBULATORY SURGERY CENTER LP | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20527 | $195.00 | 1417958729 - MENTOR SURGERY CENTER LTD | 341863257 - (OH) MENTOR SURGERY CENTER,LTD | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20527 | $123.00 | 1497740617 - LAKE COUNTY PAIN & DIAGNOSTIC | 651216636 - (OH) LAKE COUNTY PAIN DIAGNOSTIC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20527 | $664.00 | 1316189095 - CARILLON SURGERY CENTER LLC | 261116740 - (FL) CARILLON SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20527 | $128.00 | 1922070911 - FAYETTEVILLE ASC LLC, NORTH HILLS GASTROENTEROLOGY ENDOSCOPY CENTER | 621691451 - (AR) FAYETTEVILLE ASC LLC | AR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20527 | $91.00 | 1407828494 - INDEPENDENCE ASC LLC, THE ENDOSCOPY CENTER - EAST | 621707564 | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 20527 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 20527 code is part of the Surgery services used for Surgical Procedures on the Musculoskeletal System. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 20527 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 20526-CPT | Low | Injection, Therapeutic (Eg, Local Anesthetic, Corticosteroid), Carpal Tunnel |
| 20527-CPT | Low | Injection, Enzyme (Eg, Collagenase),Palmar Fascial Cord (Ie, Dupuytren's Contracture) |
| 20553-CPT | Low | Injection(S); Tendon Sheath, Ligament; Single Or Multiple Trigger Point(S), Three Or More Muscles |
| 20600-CPT | Low | Arthrocentesis Aspiration And/Or Injection; Smalljoint Bursa(Eg Fingers Toes);Without Ultrasound Guidance (Desc Revised 1/1/15) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 20527. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 20527 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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