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See a sample rate comparisonCPT 27158 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.
Pelvic Bone Surgery, Surgery To Cut A Bone In The Pelvis So That The Pelvis As A Whole Aligns Properly. This Surgery Often Corrects A Condition Present From Birth.
| 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 52 - Reduced Services LT - Left side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 27158 |
| Medicaid Fee Schedule | View Medicaid rates for 27158 |
National average reimbursement for CPT 27158 by major payers:
$1,704.08
$1,877.16
$1,930.21
$2,265.52
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CPT 27158
5 of 25 sample ratesHigher to lower in this preview
Franciscan Orthopedic Surgery Center LLC
$11,797.00Published rateUs Cardio Of Sa, LLC
Us Cardio Of Sa LLC
$5,000.00Published rateParamount Surgery Center, LLC, The Center For Specialized Surgery
Paramount Surgery Center LLC
$3,900.00Published rateHanover Surgicenter, L.L.C.
$2,460.00Published rateAlliance Surgery Center At Cumming
$1,500.00Published rate
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See a sample payer proposalCPT 27158 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 27158 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 27158 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 |
|---|---|---|
| 27096-CPT | Moderate | Injection Procedure For Sacroi, Injection Procedure For Sacroiliac Joint Anestheticsteroid With Image Guidance (Fluoroscopy Or Ct) Including Arthrography When Performed |
| 27151-CPT | High | Osteotomy Iliac Actabular Or Innominat Bone; W/ Fmoral Osteotom, Osteotomy Iliac Acetabular Or Innominate Bone; With Femoral Osteotom |
| 27156-CPT | High | Osteotomy Iliac Actabular Or Innominat Bone; W/ Fmoral Osteotom, Osteotomy Iliac Acetabular Or Innominate Bone; With Femoral Osteotom |
| 27158-CPT | High | Pelvic Bone Surgery, Surgery To Cut A Bone In The Pelvis So That The Pelvis As A Whole Aligns Properly. This Surgery Often Corrects A Condition Present From Birth. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 27158. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 27158 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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