CPT 20615 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 | Moderate |
| Medicare Fee Schedule | View Medicare rates for 20615 |
National average reimbursement for CPT 20615 by major payers:
$309.30
$318.79
$339.69
$413.25
| 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 20615 | ||||||
United | 20615 | $274.00 | 1093766289 - CAPITAL WOMENS CARE LLC, FREDERICK OB/GYN AMBULATORY SURGERY CENTER | 522112078 - (MD) CAPITAL WOMENS CARE, LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20615 | $2163.00 | 1790130672 - PROSPECT DCMH, LLC, SHORT PROCEDURE UNIT | 811520273 | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20615 | $427.26 | 1649244781 - SRIDHAR BANURU | 350593390 - DEACONESS HOSPITAL INC | KY | Cardiovascular Disease Physician (207RC0000X) |
United | 20615 | $430.00 | 1609949551 - NORTHWEST VISION INSTITUTE, PLLC, NORTHWEST LASER AND SURGERY CENTER | 383807987 - (WA) NORTHWEST VISION INSTITUTE, PLLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20615 | $2508.00 | 1770810798 - MIDTOWN SURGERY CENTER, LLC | 271462435 - (NY) MIDTOWN SURGERY CENTER, LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20615 | $400.00 | 1922028265 - ATLANTIC GASTRO SURGICENTER, LLC, T/A ACCESS | 223645443 - (NJ) ATLANTIC GASTRO SURGICENTER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20615 | $4351.00 | 1104996768 - GREATER DAYTON SURGERY CENTER LLC | 202913367 - (OH) GREATER DAYTON SURGERY CENTER | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20615 | $967.00 | 1942264619 - METROPOLITAN MEDICAL PARTNERS LLC, SURGERY CENTER OF CHEVY CHASE | 522303928 - (MD) METROPOLITAN MEDICAL PARTNERS LL | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20615 | $953.00 | 1811433410 - OPHTHALMOLOGY SURGERY CENTER OF ORLANDO LLC, ORLANDO OPHTHALMOLOGY SURGERY CENTER | 814378043 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20615 | $901.00 | 1861041139 - KADLEC REGIONAL MEDICAL CENTER, KADLEC AMBULATORY ENDOSCOPY CENTER, LEE CAMPUS | 910655392 - KADLEC REGIONAL MEDICAL CENTER | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20615 | $893.00 | 1790252864 - TREASURE COAST ASC, LLC, TREASURE COAST CENTER FOR SURGERY | 384092821 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20615 | $184.00 | 1487779435 - LAKEFOREST AMBULATORY SURGERY CENTER, DISTRICT HEIGHTS AMBULATORY SURGERY CENTER | 521944179 - (MD) LAKEFOREST AMBULATORY SURGERY CENTER | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20615 | $605.00 | 1891701611 - ESSEX ENDOSCOPY CENTER LLC | 223777761 - (NJ) ESSEX ENDOSCOPY CENTER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20615 | $341.00 | 1134135213 - MORGANTON EYE PHYSICIANS, P.A., SURGERY CENTER OF MORGANTON EYE PHYSICIANS | 561109834 - (NC) MORGANTON EYE PHYSICIANS, P.A. | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20615 | $2666.00 | 1508837899 - MEMORIAL HERMANN SURGERY CENTER NORTHWEST, LLP, MEMORIAL HERMANN SURGERY CENTER GREATER HEIGHTS | 200689650 - (TX) MEMORIAL HERMANN SURGERY CENTER NORTHWEST LLP | TX | 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 20615 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 20615 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 20615 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 |
|---|---|---|
| 20550-CPT | Low | Inj Tendon Sheath Lig Trigger Pnt Gangli |
| 20600-CPT | Low | Arthrocentesis Aspiration And/Or Injection; Smalljoint Bursa(Eg Fingers Toes);Without Ultrasound Guidance (Desc Revised 1/1/15) |
| 20610-CPT | Low | Arthrocentesis Aspiration And/Or Injection; Majorjoint Or Bursa (Eg Shoulder Hip Knee Joint Su Bacromial Bursa); Without Ultrasound Guidance (Desc Revised 1/1/2015) |
| 20615-CPT | Moderate | Asp & Inj Treat Bone Cyst |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 20615. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 20615 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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