CPT 27100 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.
| Key Fact | Detail |
|---|---|
| Service Type | Repair, Revision, and/or Reconstruction Procedures on the Pelvis and Hip Joint Surgical Procedures on the Pelvis and Hip Joint |
| Common Place of Service | 21 - Inpatient Hospital 24 - Ambulatory Surgical Center 22 - On Campus Outpatient Hospital |
| Common Modifiers | None RT - Right side of body LT - Left side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 27100 |
National average reimbursement for CPT 27100 by major payers:
$1,105.17
$1,115.57
$1,126.16
$1,361.03
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
United | 27100 | $1648.00 | 1578505079 - TRUXTUN SURGERY CENTER INC | 770414100 - (CA) TRUXTUN SURGERY CENTER, INC. | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27100 | $1800.00 | 1689635757 - ATLANTICARE SURGERY CENTER LLC | 223491867 | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27100 | $3200.00 | 1902447386 - SEATTLE PAIN RELIEF PLLC, FEDERAL WAY AMBULATORY SURGICAL FACILITY | 455527273 - (WA) SEATTLE PAIN RELIEF PLLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27100 | $835.00 | 1922054410 - BRUNSWICK ENDOSCOPY CENTER, LLC | 582301413 - (GA) BRUNSWICK ENDOSCOPY CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27100 | $1218.00 | 1851623961 - ALEXANDER EYE SURGERY CENTER, LLC | 271458954 | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27100 | $2625.00 | 1801317904 - AUSTIN KIDNEY ASSOCIATES, P. A. | 461801594 - (TX) AUSTIN KIDNEY ASSOCIATES, P.A. | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27100 | $9241.00 | 1780853044 - HACIENDA SURGERY CENTER, LLC | 320439356 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27100 | $2578.00 | 1457387771 - FOOT & ANKLE SURGERY CENTER | 582658964 - (GA) FOOT ANKLE SURGERY CENTER | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27100 | $2556.00 | 1447661145 - ADVANCED OUTPATIENT SURGERY OF OKLAHOMA, LLC | 371751472 - (OK) ADVANCED OUTPATIENT SURGERY OF | OK | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27100 | $3139.00 | 1497752745 - ORTHOPEDIC SOUTH SURGICAL PARTNERS, LLC, ORTHOPAEDIC SOUTH SURGICAL CENTER | 260008898 - (GA) ORTHOPEDIC SOUTH SURGICAL PARTNERS LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27100 | $3770.00 | 1720227945 - WESTERN CONNECTICUT ORTHOPEDIC SURGICAL CENTER LLC, THE HAND CENTER OF WESTERN CONNECTICUT LLC | 61521999 - (CT) THE HAND CENTER OF WESTERN CONNECTICUT, L.L.C. | CT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27100 | $3200.00 | 1598412256 - GEORGIA UROLOGY, PA | 550846177 | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27100 | $1641.00 | 1427098201 - LAKE AREA SURGICARE LLC, SURGICARE OF LAKE CHARLES | 621658994 - (LA) LAKE AREA SURGICARE LLC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27100 | $2174.00 | 1225776230 - ADVANCED AMBULATORY SURGICAL CENTER LLC | 871669738 - (KS) ADVANCED AMBULATORY SURGICAL CENTER LLC | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27100 | $1550.00 | 1306119615 - BARNET DULANEY PERKINS EYE CENTER, PC, AMERICAN VISION PARTNERS | 562589722 - BARNET DULANEY PERKINS EYE CENTER PLLC | AZ | 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 27100 vs. Other Surgical Procedures on the Pelvis and Hip Joint Codes
The CPT 27100 code is part of the Repair, Revision, and/or Reconstruction Procedures on the Pelvis and Hip Joint services used for Surgical Procedures on the Pelvis and Hip Joint. 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 27100 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 |
|---|---|---|
| 27100-CPT | High | Reposition A Hip Muscle, Surgery To Transfer A Muscle To A New Location In The Hip. A Functioning Hip Muscle Replaces One That Has Become Paralyzed. |
| 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. |
| 27120-CPT | High | Surgical Repair Of Hip Socket, Surgery To Restore Socket Of Hip Joint (Acetabulum) To Its Normal State. Any Damaged Or Infected Bone Or Material Is Removed. A Cast Is Applied. |
| 27125-CPT | High | Hemiarthroplas Hip Partial (Eg Fmoral Stem Prosthes Bipolar, Hemiarthroplasty Hip Partial (Eg Femoral Stem Prosthesis Bipolar A |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 27100. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 27100 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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