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See a sample rate comparisonCPT 27054 Fee Schedule
Last Verified: September 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.
Removal Of Lining Of Hip Joint, Exploration Of Hip Joint. The Procedure Includes Removal Of Inflamed Joint Lining To Alleviate Pain.
| 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 | 59 - Distinct Procedural Service AS - PA/NP/CNS assistant at surgery RT - Right side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 27054 |
| Medicaid Fee Schedule | View Medicaid rates for 27054 |
National average reimbursement for CPT 27054 by major payers:
$878.00
$925.54
$951.32
$1,134.10
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CPT 27054
5 of 25 sample ratesHigher to lower in this preview
Laguna Niguel Surgery Center LLC
$7,366.00Published rateProhealth Aligned LLC, Prohealth Care Moreland Surgery Center
Prohealth Aligned LLC
$3,487.00Published rateCongress Medical Surgery Center LLC
$1,880.00Published rateWolfe Surgery Center, LLC
Wolfe Surgery Center LLC
$1,323.00Published rateSurgical Center Of Peak Endoscopy, LLC
Surgical Center Of Peak Endoscopy LLC
$747.00Published rate
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See a sample payer proposalCPT 27054 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 27054 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 27054 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 |
|---|---|---|
| 27050-CPT | Moderate | 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 | Moderate | Exploratory Surgery Of The Hip, Surgery To Explore A Hip Joint. The Procedure Removes A Sample Of Tissue For Testing (Biopsy). |
| 27054-CPT | Moderate | Removal Of Lining Of Hip Joint, Exploration Of Hip Joint. The Procedure Includes Removal Of Inflamed Joint Lining To Alleviate Pain. |
| 27057-CPT | High | 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 27054. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 27054 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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