CPT 27048 Fee Schedule
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.
| Key Fact | Detail |
|---|---|
| Service Type | • Surgery • Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | • 22 - On Campus Outpatient Hospital • 21 - Inpatient Hospital |
| Common Modifiers | • None • RT - Right side of body • LT - Left side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 27048 |
National average reimbursement for CPT 27048 by major payers:
$798.66
$783.25
$828.02
$991.95
| 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 27048 | ||||||
United | 27048 | $994.00 | 1093461410 - INFIRMARY ASC | 871933440 - (AL) INFIRMARY ASC | AL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27048 | $700.00 | 1275008351 - CENTER FOR SPECIAL SURGERY LLC | 830951938 - (GA) CENTER FOR SPECIAL SURGERY LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27048 | $581.00 | 1992384739 - SURGERY CENTER OPERATIONS, LLC | 851921698 - (FL) SURGERY CENTER OPERATIONS LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27048 | $713.00 | 1477586576 - BUFFALO AMBULATORY SERVICES, INC, BUFFALO AMBULATORY SURGERY CENTER | 161348390 - (NY) BUFFALO AMBULATORY SERVICES, INC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27048 | $577.00 | 1326563537 - OPTUMCARE COLORADO ASC, LLC | 352597463 | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27048 | $423.00 | 1831167329 - THIBODAUX ENDOSCOPY LLC | 810548522 - (LA) THIBODAUX ENDOSCOPY, L.L.C. | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27048 | $406.00 | 1255314662 - MAZZOCCO AMBULATORY SURGICAL CENTER | 954505995 - (CA) MAZZOCCO AMBULATORY SURGICAL CENTER | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27048 | $1258.00 | 1730318353 - GARDENDALE SURGICAL ASSOCIATES, LLC | 205936644 - (AL) GARDENDALE SURGICAL ASSOCIATES | AL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27048 | $726.00 | 1316231020 - DESERT VIEW ENDOSCOPY CENTER, LLC. | 272420135 - (CA) DESERT VIEW ENDOSCOPY CENTER LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27048 | $1188.00 | 1104233014 - TAMPA MINIMALLY INVASIVE SPINE SURGERY CENTER, LLC | 471211888 - (FL) TAMPA MINIMALLY INVASIVE SPINE SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27048 | $725.00 | 1265495451 - EXECUTIVE WOODS AMBULATORY SURGERY CENTER LLC | 141819770 - (NY) EXECUTIVE WOODS AMBULATORY SURGERY CENTER LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27048 | $670.00 | 1922531268 - AMERICAN ACCESS CARE OF BALTIMORE ASC LLC | 814584087 - (MD) AMERICAN ACCESS CARE OF BALTIMORE ASC LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27048 | $2675.00 | 1932146990 - CHCA MAINLAND, L.P., MAINLAND MEDICAL CENTER | 621801360 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27048 | $544.00 | 1215126438 - THE ARCADIA CA ENDOSCOPY ASC LP, VALLEY DIGESTIVE HEALTH CENTER | 204484163 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27048 | $1809.00 | 1417534207 - MEDICAL CITY SURGERY CENTER OF FRISCO, LLC | 822432064 - (TX) MEDICAL CITY SURGERY CENTER OF FRISCO LLC | TX | 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 27048 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 27048 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 27048 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 Soft Tissue Hip Superficial |
| 27041-CPT | Moderate | Biopsy, Soft Tissues;Deep-Pelvis/Hip |
| 27043-CPT | Moderate | Removal (3 Centimeters Or Greater) Tissue Growth Beneath The Skin Of Pelvis Or Hip |
| 27048-CPT | Moderate | Excision, Tumor, Soft Tissue Of Pelvis And Hip Area, Subfascial (Eg, Intramuscular); Less Than 5 Cm |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 27048. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 27048 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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