CPT 27025 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address high-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 | • 24 - Ambulatory Surgical Center • 22 - On Campus Outpatient Hospital • 21 - Inpatient Hospital |
| Common Modifiers | • None • RT - Right side of body • LT - Left side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 27025 |
National average reimbursement for CPT 27025 by major payers:
$1,207.80
$1,222.06
$1,273.92
$1,530.65
| 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 27025 | ||||||
United | 27025 | $3012.00 | 1194275230 - WEST SUBURBAN EYE SURGERY CENTER LLC, SURGISITE NORTH | 201671234 - (MA) WEST SUBURBAN EYE SURGERY CENTER, LLC | MA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27025 | $1039.00 | 1699748855 - MIDDLETOWN ENDOSCOPY ASC LLC, THE GI ENDOSCOPY CENTER | 621835826 - (OH) MIDDLETOWN ENDOSCOPY ASC LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27025 | $3943.00 | 1609400290 - ORTHOPAEDIC ASSOCIATES OF CENTRAL TEXAS SURGERY CENTER, LLC | 844818321 - (TX) ORTHOPAEDIC ASSOCIATES OF CENTRAL TEXAS SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27025 | $3713.00 | 1982873352 - BAHAMAS SURGERY CENTER LLC | 208025178 - (CA) BAHAMAS SURGERY CENTER LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27025 | $1802.00 | 1982105458 - HEART CARE CENTER, LLC | 824195385 | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27025 | $1900.00 | 1477500767 - SOUTHPOINT SURGERY CENTER, LLC | 203579196 - (FL) SOUTHPOINT SURGERY CENTER, LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27025 | $1957.00 | 1801822739 - SYLVAN SURGERY CENTER, INC. | 200500901 - (CA) SYLVAN SURGERY CENTER INC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27025 | $4764.00 | 1437871373 - NORTHEAST INDIANA AMBULATORY SURGERY CENTER LLC | 830979985 - (IN) NORTHEAST INDIANA AMBULATORY SURGERY CENTER LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27025 | $2800.00 | 1386177376 - EXECUTIVE SURGERY CENTER OF LITTLE ROCK, LLC | 820817194 - (AR) EXECUTIVE SURGERY CENTER OF LITTLE ROCK LLC | AR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27025 | $6588.00 | 1932636123 - TUCSON DIGESTIVE INSTITUTE LLC, ARIZONA DIGESTIVE INSTITUTE | 821568426 | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27025 | $1604.00 | 1588802987 - NATIONAL PARK ENDOSCOPY CENTER, LLC, SOUTH CENTRAL ENDOSCOPY | 260359982 - (AR) NATIONAL PARK ENDOSCOPY CENTER LLC | AR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27025 | $3680.00 | 1043271604 - NORTH FULLERTON SURGERY CENTER, LLC | 223849885 - (NJ) NORTH FULLERTON SURGERY CENTER, LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27025 | $4642.00 | 1235715996 - CENTRAL UTAH SURGICENTER, LLC | 862348485 - (UT) CENTRAL UTAH SURGICENTER LLC | UT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27025 | $1687.00 | 1336310986 - LAPLATA AMBULATORY UROLOGICAL CENTER, L.L.C. | 262119326 - (MD) LAPLATA AMBULATORY UROLOGICAL CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27025 | $6588.00 | 1184714214 - GAINESVILLE ENDOSCOPY CENTER, LLC | 10750801 - (GA) GAINESVILLE ENDOSCOPY CENTER LLC | GA | 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 27025 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 27025 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 27025 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 |
|---|---|---|
| 27006-CPT | High | Tenotomy Abductors Hip Open |
| 27025-CPT | High | Fasciot.,Hip/Thigh,Any Type |
| 27027-CPT | High | Decompression Fasciotomy(Ies) Pelvic (Buttock) Compartment(S) (Eg Gluteus Medius-Minimus Gluteus Maximus Iliopsoas And/Or Tensor Fascia Lata Muscle) Unilateral |
| 27030-CPT | High | Arthrotomy,Hip,For Infec,W/Drainage |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 27025. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 27025 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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