Rate Benchmarking
Compare your rates with similar providers.
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonCPT 27052 Fee Schedule
Medicare rates as of October 2026
CPT 27052 is classified under Surgery, in the Surgical Procedures on the Musculoskeletal System subgroup.
Exploratory Surgery Of The Hip, Surgery To Explore A Hip Joint. The Procedure Removes A Sample Of Tissue For Testing (Biopsy).
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 21Inpatient Hospital 11Office |
| Common Modifiers | RTRight side of body LTLeft side of body |
| Hospital Outpatient Group (APC) | APC 5112 - Level 2 Musculoskeletal Procedures |
| Surgery Center Payment (ASC) | A2 - Paid separately, from the OPPS relative weight |
| Common Revenue Codes | 03600361 |
| Medicare Fee Schedule | $556.46 national non-facility rate (2026)View Medicare rates for 27052 |
| Medicaid Fee Schedule | $439.325 median of the 8 states in the free previewView Medicaid rates for 27052 |
National average reimbursement for CPT 27052 by major payers:
$786.21
BCBS / Anthem
$767.86
UnitedHealthcare
$786.92
Aetna
$947.56
Cigna
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 27052.
CPT 27052
5 of 25 sample ratesHigher to lower in this preview
North Central Methodist Asc, Lp, Methodist Ambulatory Surgery Center North Central
North Central Methodist Asc Lp
$5,007.00Published rateLakewood Ranch Surgical Suites, LLC
Lakewood Ranch Surgical Suites LLC
$2,353.00Published rateSouthside Specialty Surgical Center LLC
$1,645.00Published rateOmaha Ambulatory Surgery Center LLC
$1,223.00Published rateHattiesburg Clinic PA, Ambulatory Surgery Center
Hattiesburg Clinic, P.A.
$767.00Published rate
Get a free rate benchmark for your specialty.
Choose your state and specialty to build a report from payer-published rates.
Looking for other data?
Use market rates to prepare your payer proposal.
Payer Contract Negotiation
Draft a fee schedule renegotiation letter.
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 27052 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The table lists codes related to 27052. Select one to see its fee schedule.
| Code | Description |
|---|---|
| 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). |
| 27054-CPT | Removal Of Lining Of Hip Joint, Exploration Of Hip Joint. The Procedure Includes Removal Of Inflamed Joint Lining To Alleviate Pain. |
| 27057-CPT | Surgery Ease Tissue Pressure, Surgery To Cut Fascia (Strong Connective Tissue That Surrounds Muscle Bone And Organs) In Buttock Or Pelvic Area; To Relieve Pressure From Swelling In A Confined Body Area (Compartment Syndrome). This Serious Condition Can Lead To Tissue Death Or Amputation. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 27052. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 27052 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.
FREE SAMPLE MARKET COMPARISON
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 27052) and we'll show you how you compare in 15 minutes or less.
Frequently Asked Questions
What APC is CPT 27052 assigned to?
Medicare's hospital outpatient payment system (OPPS) assigns CPT 27052 to APC 5112 (Level 2 Musculoskeletal Procedures). An APC groups outpatient services that Medicare pays at the same base rate.
How does Medicare pay for CPT 27052 in an ambulatory surgery center?
CMS lists CPT 27052 with ASC payment indicator A2: Paid separately, from the OPPS relative weight.
Which revenue codes are billed with CPT 27052?
Hospital price transparency files list CPT 27052 under these revenue codes: 0360 and 0361. A revenue code names the hospital department or charge category for the line; it does not change what the service is.