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See a sample rate comparisonCPT 27097 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.
Recession Hamstring Proximal
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 21 - Inpatient Hospital 22 - On Campus Outpatient Hospital |
| Common Modifiers | None 50 - Bilateral Procedure RT - Right side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 27097 |
| Medicaid Fee Schedule | View Medicaid rates for 27097 |
National average reimbursement for CPT 27097 by major payers:
$919.58
$912.74
$968.81
$1,116.39
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CPT 27097
5 of 25 sample ratesHigher to lower in this preview
Beltway Surgery Centers, LLC, Meridian South Surgery Center
$6,285.00Published rateClearway Surgery Center Of National Harbor LLC
Harborside Surgery Center
$2,490.00Published rateChicago Vascular Asc LLC
$1,823.00Published rateMilan S Chakrabarty Md
$1,430.00Published rateAlta-Rose Surgery Center LLC
$678.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 27097 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 27097 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 27097 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 |
|---|---|---|
| 27097-CPT | Moderate | Recession Hamstring Proximal |
| 27098-CPT | Moderate | Move Tendon In Hip, A Functioning Tendon In The Hip Is Detached From Its Original Attachment To A Bone And Re-Sewn Onto A Different Bone Or Tendon. |
| 27110-CPT | High | Move Tendon At Front Of Hip, A Functioning Iliopsoas Tendon Is Detached And Re-Sewn Onto A Different Location Of The Hip Bone. The Procedure Is Done To Relieve Pain And Spasm And Increase Hip Function. |
| 27156-CPT | High | Osteotomy Iliac Actabular Or Innominat Bone; W/ Fmoral Osteotom, Osteotomy Iliac Acetabular Or Innominate Bone; With Femoral Osteotom |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 27097. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 27097 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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