CPT 27030 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 | • 21 - Inpatient Hospital • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • RT - Right side of body • LT - Left side of body |
| Complexity Level | High |
National average reimbursement for CPT 27030 by major payers:
$1,194.01
$1,270.93
$1,331.78
$1,568.68
| 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 27030 | ||||||
United | 27030 | $1631.71 | 1588644744 - DELLA EVANS | 350593390 - DEACONESS HOSPITAL INC | IN | Geriatric Medicine (Family Medicine) Physician (207QG0300X) |
United | 27030 | $1230.00 | 1326170036 - TAMPA BAY EYE SURGERY CENTER, LLC | 273286942 - (FL) TAMPA BAY EYE SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27030 | $8477.00 | 1740318153 - PLAZA SURGERY CENTER, L.P., PLAZA SURGERY CENTER | 770573567 - (CA) PLAZA SURGERY CENTER LP | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27030 | $4010.00 | 1447355243 - SURGICENTER OF GREATER MILWAUKEE, LLC, SURGICENTER OF GREATER MILWAUKEE, INC. | 391682308 - (WI) CHILDREN'S HOSPITAL AND HEALTH SYSTEM, INC. | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27030 | $2100.00 | 1275836645 - BROOKSTONE AMBULATORY SURGERY CENTER | 263097292 - (GA) BROOKSTONE AMBULATORY SURGERY CENTER | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27030 | $1496.00 | 1366799033 - UPSTATE GASTROENTEROLOGY, LLC | 270998899 - (NY) UPSTATE GASTROENTEROLOGY LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27030 | $1650.00 | 1871529388 - PRG DALLAS ASC, LLC, CENTRAL POINT SURGERY CENTER | 752835144 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27030 | $7500.00 | 1750892659 - NOVANT HEALTH KERNERSVILLE OUTPATIENT SURGERY LLC | 821651821 - (NC) NOVANT HEALTH KERNERSVILLE OUTPATIENT SURGERY LLC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27030 | $2726.00 | 1154326650 - SCOTTSDALE SURGICAL PARTNERS LLC, NORTH VALLEY SURGERY CENTER | 201808351 | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27030 | $2945.00 | 1740787068 - CLEVELAND CLINIC FLORIDA (A NONPROFIT CORPORATION), CLEVELAND CLINIC FLORIDA CORAL SPRINGS ASC | 650003177 - CLEVELAND CLINIC FLORIDA A NONPROFIT CORPORATION | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27030 | $1631.71 | 1316047996 - DEIRDRE DURKIS | 350593390 - DEACONESS HOSPITAL INC | IN | Anesthesiology Physician (207L00000X) |
United | 27030 | $1808.00 | 1750974176 - NCBH OUTPATIENT ENDOSCOPY CENTER, L.L.C., WAKE FOREST BAPTIST HEALTH OUTPATIENT ENDOSCOPY - QUAKER LANE | 270668137 - (NC) NCBH OUTPATIENT ENDOSCOPY CENTER LLC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27030 | $1590.00 | 1043612534 - HHC ASC, LLC | 824195385 | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27030 | $2019.00 | 1821279720 - NEW ORLEANS LA UPTOWN WEST BANK ENDOSCOPY ASC LLC, MGA GASTROINTESTINAL DIAGNOSTIC AND THERAPEUTIC CENTER | 205904530 | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27030 | $7508.00 | 1275596264 - CAROLINA REGIONAL SURGERY CENTER. LTD | 621616402 - (SC) CAROLINA REGIONAL SURGERY CENTER LTD | SC | 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 27030 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 27030 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 27030 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 |
|---|---|---|
| 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 |
| 27033-CPT | High | Arthrotomy Hip W Expl/Rem Loose/Fb |
| 27050-CPT | Moderate | Arthrotomy,For Bx;Sacroiliac Joint |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 27030. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 27030 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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