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See a sample rate comparisonCPT 27040 Fee Schedule
Last Verified: October 2026
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.
Biopsy Of Tissue Under Skin, A Procedure To Remove A Sample Of Soft Tissue From Near The Skin Surface For Testing (Biopsy).
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 11 - Office 24 - Ambulatory Surgical Center |
| Common Modifiers | None 51 - Multiple procedures LT - Left side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 27040 |
| Medicaid Fee Schedule | View Medicaid rates for 27040 |
National average reimbursement for CPT 27040 by major payers:
$415.59
$449.93
$458.81
$538.60
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CPT 27040
5 of 25 sample ratesHigher to lower in this preview
Silicon Valley Surgery Center, Lp
Silicon Valley Surgery Center, L.P.
$3,435.00Published rateSurgcenter At Paradise Valley, LLC, Surgcenter At Pima Crossing
Surgcenter At Paradise Valley
$967.00Published rateAdeel Siddiqui
Deaconess Hospital Inc
$601.88Published rateEast Jefferson Ambulatory Surgery Center
East Jefferson Ambulatory
$389.00Published rateHendi Ambulatory Surgery Center, PC
Hendi Ambulatory Surgery Center PC
$221.00Published rate
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See a sample payer proposalCPT 27040 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 27040 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 27040 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 |
|---|---|---|
| 27040-CPT | Moderate | Biopsy Of Tissue Under Skin, A Procedure To Remove A Sample Of Soft Tissue From Near The Skin Surface For Testing (Biopsy). |
| 27041-CPT | Moderate | Biops Sft Tissue Of Pelvis/Hip Area; Deep Subfasci Or Intram, Biopsy Soft Tissue Of Pelvis And Hip Area; Deep Subfascial Or Intram |
| 27043-CPT | Moderate | Xcision Tumor Sft Tissue Of Pelvis & Hip Area Subcutane, Excision Tumor Soft Tissue Of Pelvis And Hip Area Subcutaneous; 3 C |
| 27045-CPT | High | Exc Hip Pelv Tum Deep 5 Cm, Excision Tumor Soft Tissue Of Pelvis And Hip Area Subfascial Eg Intramuscular 5 Cm Or Greater |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 27040. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 27040 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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