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See a sample rate comparisonCPT 27030 Fee Schedule
Medicare rates as of October 2026
CPT 27030 is classified under Surgery, in the Surgical Procedures on the Musculoskeletal System subgroup.
Arthrotomy,Hip,For Infec,W/Drainage
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 21Inpatient Hospital 22On Campus Outpatient Hospital |
| Common Modifiers | RTRight side of body LTLeft side of body |
| Hospital Outpatient Group (APC) | APC 5114 - Level 4 Musculoskeletal Procedures |
| Surgery Center Payment (ASC) | G2 - Paid separately, from the OPPS relative weight |
| Add-on Codes | 2070020704Sign up to view all 3 |
| Common Revenue Codes | 03600960Sign up to view all 3 |
| Medicare Fee Schedule | $860.74 national non-facility rate (2026)View Medicare rates for 27030 |
| Medicaid Fee Schedule | $684.125 median of the 8 states in the free previewView Medicaid rates for 27030 |
National average reimbursement for CPT 27030 by major payers:
$1,194.01
BCBS / Anthem
$1,270.93
UnitedHealthcare
$1,331.78
Aetna
$1,534.13
Cigna
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 27030.
CPT 27030
5 of 25 sample ratesHigher to lower in this preview
Plaza Surgery Center, L.P., Plaza Surgery Center
Plaza Surgery Center Lp
$8,477.00Published rateNew Vista Health, LLC, Piney Point Surgery Center
$4,312.00Published rateHuntington Specialty Surgery LLC
$2,900.00Published rateRiverwalk Ambulatory Surgery Center LLC
Riverwalk Ambulatory Surgery Center, LLC
$1,750.00Published rateAdvanced Ambulatory Surgery Center, LLC
Advanced Ambulatory Surgery Center LLC
$814.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 27030 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The table lists codes related to 27030. Select one to see its fee schedule.
| Code | Description |
|---|---|
| 27030-CPT | Arthrotomy,Hip,For Infec,W/Drainage |
| 27033-CPT | Arthrotomy Hip Including Exp, Arthrotomy Hip Including Exploration Or Removal Of Looseor Foreign Body Arthrotomy Hip Including Exploration Or Removal Of Loose |
| 27050-CPT | Joint Surgery Base Of Spine, Surgery To Explore The Joint At The Base Of The Spine (Sacroiliac Joint). The Procedure Includes Removing A Sample Of Tissue For Testing (Biopsy). |
| 27052-CPT | Exploratory Surgery Of The Hip, Surgery To Explore A Hip Joint. The Procedure Removes A Sample Of Tissue For Testing (Biopsy). |
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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Frequently Asked Questions
What APC is CPT 27030 assigned to?
Medicare's hospital outpatient payment system (OPPS) assigns CPT 27030 to APC 5114 (Level 4 Musculoskeletal Procedures). An APC groups outpatient services that Medicare pays at the same base rate.
How does Medicare pay for CPT 27030 in an ambulatory surgery center?
CMS lists CPT 27030 with ASC payment indicator G2: Paid separately, from the OPPS relative weight.
Which add-on codes are billed with CPT 27030?
CMS add-on code edits list CPT 27030 as a primary code for these add-on codes: 20700, 20704 and 20705.
Which revenue codes are billed with CPT 27030?
Hospital price transparency files list CPT 27030 under these revenue codes: 0360, 0960 and 0975. A revenue code names the hospital department or charge category for the line; it does not change what the service is.