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See a sample rate comparisonCPT 27125 Fee Schedule
Last Verified: October 2026
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.
Hemiarthroplas Hip Partial (Eg Fmoral Stem Prosthes Bipolar, Hemiarthroplasty Hip Partial (Eg Femoral Stem Prosthesis Bipolar A
| 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 LT - Left side of body RT - Right side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 27125 |
| Medicaid Fee Schedule | View Medicaid rates for 27125 |
National average reimbursement for CPT 27125 by major payers:
$1,521.28
$1,525.23
$1,603.17
$1,847.61
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CPT 27125
5 of 25 sample ratesHigher to lower in this preview
Columbia North Hills Hospital Subsidiary Lp, Medical City North Hills
Columbia North Hills Hospital Subsidiary Lp
$17,452.00Published rateGlenwood Surgical Center L P
Glenwood Surgical Center Lp
$5,454.00Published rateParamount Surgery Center, LLC, The Center For Specialized Surgery
Paramount Surgery Center LLC
$3,900.00Published rateAtlanticare Surgery Center LLC
Atlanticare Health System Inc
$2,788.00Published rateEndosurg Outpatient Center LLC
$740.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 27125 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 27125 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 27125 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 |
|---|---|---|
| 27090-CPT | High | Removal Prosthesis Hip |
| 27122-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 |
| 27130-CPT | High | Surgical Service Bundle Includes All Surgery Related Health Services Which Are Incurred In Connection With An Approved Outpatient Surgical Procedure, Billed Via The Agreed Upon Cpt Codes And Reimbursed At A Single Payment Rate Including All Services Such |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 27125. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 27125 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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