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See a sample rate comparisonCPT 27054 Fee Schedule
Medicare rates as of October 2026
CPT 27054 is classified under Surgery, in the Surgical Procedures on the Musculoskeletal System subgroup.
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 | 22On Campus Outpatient Hospital 21Inpatient Hospital |
| Common Modifiers | 59Distinct Procedural Service ASPA/NP/CNS assistant at surgery RTRight side of body |
| Hospital Outpatient Group (APC) | APC 5113 - Level 3 Musculoskeletal Procedures |
| Surgery Center Payment (ASC) | G2 - Paid separately, from the OPPS relative weight |
| Common Revenue Codes | 0360 |
| Medicare Fee Schedule | $651.32 national non-facility rate (2026)View Medicare rates for 27054 |
| Medicaid Fee Schedule | $521.385 median of the 8 states in the free previewView Medicaid rates for 27054 |
National average reimbursement for CPT 27054 by major payers:
$878.00
BCBS / Anthem
$925.54
UnitedHealthcare
$951.32
Aetna
$1,134.10
Cigna
Compare published rates across providers.
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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 table lists codes related to 27054. 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 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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Frequently Asked Questions
What APC is CPT 27054 assigned to?
Medicare's hospital outpatient payment system (OPPS) assigns CPT 27054 to APC 5113 (Level 3 Musculoskeletal Procedures). An APC groups outpatient services that Medicare pays at the same base rate.
How does Medicare pay for CPT 27054 in an ambulatory surgery center?
CMS lists CPT 27054 with ASC payment indicator G2: Paid separately, from the OPPS relative weight.
Which revenue codes are billed with CPT 27054?
Hospital price transparency files list CPT 27054 under these revenue codes: 0360. A revenue code names the hospital department or charge category for the line; it does not change what the service is.