CPT 27035 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 • 11 - Office • 19 - Off Campus Outpatient Hospital |
| Common Modifiers | • None • RT - Right side of body • LT - Left side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 27035 |
National average reimbursement for CPT 27035 by major payers:
$1,467.03
$1,528.11
$1,544.82
$1,916.54
| 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 27035 | ||||||
United | 27035 | $1200.00 | 1396727418 - ENDOSCOPY CENTER OF LITTLE ROCK,LLC, RIC LR LLC | 20703428 - (AR) ENDOSCOPY CENTER OF LITTLE ROCKLLC | AR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27035 | $1613.00 | 1841378056 - FULL SPECTRUM EYE CARE, P.S., THE COLUMBIA RIVER EYE SURGERY CENTER | 911279261 - (WA) FULL SPECTRUM EYE CARE, P.S. | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27035 | $1084.00 | 1669668943 - POOLE ENDOSCOPY CENTER, NEEL KAMAL MD | 521831316 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27035 | $900.00 | 1992777643 - CAPE CORAL FT MYERS ENDOSCOPY ASC LLC, GULF COAST ENDOSCOPY CENTER SOUTH | 621767599 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27035 | $1342.00 | 1629404918 - CENTRAL ARKANSAS SURGERY CENTER, LLC | 462585307 - (AR) CENTRAL ARKANSAS SURGERY CENTER LLC | AR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27035 | $3347.00 | 1487716650 - CARONDELET ST. MARY'S NORTHWEST, LLC, CARONDELET FOOTHILLS SURGERY CENTER | 201086556 - (AZ) CAMP LOWELL SURGERY CENTER | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27035 | $734.00 | 1487651956 - TRI-STATE GASTROENTEROLOGY ASSOCIATES, PSC, TRI-STATE DIGESTIVE DISORDER CENTER | 611192347 - (KY) TRI-STATE GASTROENTEROLOGY ASSOCIATES, PSC | KY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27035 | $2475.00 | 1841507266 - SOUTH PORTLAND SURGICAL CENTER LLC, SOUTH PORTLAND SURGICAL CENTER | 800461691 - (OR) SOUTH PORTLAND SURGICAL CENTER, LLC | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27035 | $2847.00 | 1609872597 - COLISEUM SAME DAY SURGERY CENTER LP | 621805346 - (GA) COLISEUM SAME DAY SURGERY CENTER LP | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27035 | $4339.00 | 1942851639 - NORTHERN MICHIGAN SURGICAL SUITES, LLC | 830670803 - (MI) NORTHERN MICHIGAN SURGICAL SUITES, LLC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27035 | $3568.00 | 1891759569 - ST JOSEPH CENTER FOR OUTPATIENT SURGERY, LLC | 680510220 - (MO) ST JOSEPH CENTER FOR OUTPATIENT SURGERY LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27035 | $1334.00 | 1396076980 - BAY SURGERY CENTERS, CLEARWAY SURGERY CENTER OF KENT ISLAND | 271271185 - (MD) BAY SURGERY CENTERS | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27035 | $3773.00 | 1174708390 - ORTHOPAEDIC SPECIALTY SURGERY CENTER LLC, ORTHOPAEDIC & SPECIALTY SURGERY CENTER | 263119034 - (CT) ORTHOPAEDIC SPECIALTY SURGERY CENTER, LLC | CT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27035 | $1305.00 | 1336138635 - EYE SURGICAL SPECIALISTS OF NEW JERSEY, SURGERY CENTER OF CENTRAL NEW JERSEY | 223411416 - (NJ) EYE SURGICAL SPECIALISTS OF NEW JERSEY | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27035 | $1984.00 | 1306274097 - INTERVENTIONAL PAIN MANAGEMENT LLC | 452192531 - (IN) INTERVENTIONAL PAIN MANAGEMENT LLC | IN | 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 27035 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 27035 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 27035 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 |
| 27035-CPT | High | Hip Jnt Denerv,Intra/Extrapelvic Sciatic |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 27035. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 27035 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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