CPT 27105 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 | • Surgery • Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | • 21 - Inpatient Hospital • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • LT - Left side of body • None • AS - PA/NP/CNS assistant at surgery • RT - Right side of body |
| Complexity Level | High |
National average reimbursement for CPT 27105 by major payers:
$1,199.36
$1,169.15
$1,182.25
$1,457.13
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 27105 | ||||||
United | 27105 | $750.00 | 1225199482 - ST MARKS SURGICAL CENTER LLC | 364577700 - (FL) ST MARKS SURGICAL CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27105 | $1485.00 | 1255303517 - ST DOMINIC AMBULATORY SURGERY CENTER L L C | 640908713 - (MS) ST DOMINIC AMBULATORY SURGERY CENTER L L C | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27105 | $1981.00 | 1336154152 - A CENTER FOR FOOT AND ANKLE SURGERY PA, THE CENTER FOR SPECIAL SURGERY OF HAWTHORNE | 223284458 - (NJ) A CENTER FOR FOOT AND ANKLE SU | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27105 | $3426.00 | 1366137440 - SURGERY CENTER OF GEORGETOWN, LLC, GEORGETOWN SURGERY CENTER | 880604963 - (TX) SURGERY CENTER OF GEORGETOWN LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27105 | $3130.00 | 1669021283 - EL DORADO SURGERY CENTER LP, TUCSON ENDOSCOPY CENTER | 850474225 | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27105 | $2014.00 | 1457465403 - VENTURE AMBULATORY SURGERY CENTER | 743257508 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27105 | $1401.00 | 1467490433 - UROLOGY SURGICAL CENTER LLC | 470814279 - (NE) UROLOGY SURGICAL CENTER | NE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27105 | $3906.00 | 1114696234 - ONE NINETEEN GI ASC, LLC | 862162590 - (AL) ONE NINETEEN GI ASC LLC | AL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27105 | $2375.00 | 1215204128 - MINIMALLY INVASIVE NEUROSPINE AND PAIN INSTITUTE, P.C., ALLSPINE SURGERY CENTER, P.C. | 274395849 - (GA) MINIMALLY INVASIVE NEUROSPINE AND PAIN INSTITUTE PC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27105 | $2200.00 | 1225036601 - TALLGRASS SURGICAL CENTER, LLC | 481243206 - (KS) TALLGRASS SURGICAL CENTER, LLC | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27105 | $1590.00 | 1811090350 - GREEN SURGERY CENTER LLC | 621770173 - (TN) GREEN SURGERY CENTER LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27105 | $2900.00 | 1831746007 - GC SURGERY CENTER LLC | 823013393 - (GA) GC SURGERY CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27105 | $1366.00 | 1013463157 - ENDOSCOPY CENTER OF NORTH CAROLINA | 813453411 | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27105 | $2300.00 | 1952834277 - AMERICAN ACCESS CARE OF TOWSON ASC LLC | 814571016 - (MD) AMERICAN ACCESS CARE OF TOWSON ASC LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27105 | $753.00 | 1881728590 - SYSTEM OPTICS LLC | 341572960 - (OH) SYSTEM OPTICS, INC. | OH | 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 27105 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 27105 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 27105 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 |
|---|---|---|
| 27095-CPT | Moderate | Injection Procedure-Hip Arthrography;W A |
| 27096-CPT | Moderate | Injection Procedure For Sacroiliac Joint, Anesthetic/Steroid, With Image Guidance (Fluoroscopy Or Ct) Including Arthrography When Performed |
| 27105-CPT | High | Transfer Paraspinal Muscle To Hip W Graf |
| 27110-CPT | High | Transfer Iliopsoas To Trochanter |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 27105. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 27105 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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