CPT 27181 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 | • None • LT - Left side of body • RT - Right side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 27181 |
National average reimbursement for CPT 27181 by major payers:

$1,494.65

$1,490.58

$1,544.40

$1,855.04
| 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 27181 | ||||||
United | 27181 | $3605.00 | 1720048242 - MARYLAND SURGERY CENTER FOR WOMEN LLC, MARYLAND SURGERY CENTER | 522215638 - (MD) MARYLAND SURGERY CENTER FOR WOMEN, LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27181 | $3722.00 | 1770951915 - TRI-COUNTY VASCULAR CARE, LLC | 473091752 - (CA) TRICOUNTY VASCULAR CARE LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27181 | $9182.00 | 1679065759 - MEMORIAL HERMANN SURGERY CENTER BRAZORIA, LLC | 830759140 - (TX) MEMORIAL HERMANN SURGERY CENTER BRAZORIA LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27181 | $1935.00 | 1477831360 - GEORGIA OPHTHALMOLOGISTS LLC, GEORGIA OPHTHALMOLOGISTS AMBULATORY SURGERY CENTER | 452069323 - (GA) GEORGIA OPHTHALMOLOGISTS, LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27181 | $6010.00 | 1104468602 - PRESBYTERIAN HOSPITAL ASC, NEW MEXICO SURGERY CENTER MULTI-SPECIALTY | 842748057 | NM | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27181 | $15525.00 | 1508169921 - SAINT LUKES-GI DIAGNOSTICS LLC | 274142549 - (MO) SAINT LUKESGI DIAGNOSTICS LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27181 | $4134.00 | 1164771762 - MARYLAND SPECIALTY SURGERY CENTER, LLC | 454793230 - (MD) MARYLAND SPECIALTY SURGERY CENTER, LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27181 | $675.00 | 1417118241 - DIGESTIVE HEALTH COMPLEX,INC | 262808532 | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27181 | $2124.00 | 1629038989 - SAN ANTONIO EYE CENTER, PA, SAN ANTONIO EYE SURGICENTER | 741916103 - (TX) SAN ANTONIO EYE CENTER, PA | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27181 | $4356.00 | 1568906212 - HOUSTON UROLOGIC SURGICENTER, LLC | 814537533 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27181 | $4615.00 | 1508135658 - SURGERY CENTER OF ATHENS LLC | 450581955 - (GA) SURGERY CENTER OF ATHENS LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27181 | $3094.00 | 1821167479 - EVERGREEN EYE CENTER, PLLC, EVERGREEN EYE SURGERY CENTER | 911628032 - (WA) EVERGREEN EYE CENTER, INC. P.S. | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27181 | $6087.00 | 1194239483 - ATLANTIC COAST SURGICAL SUITES, LLC | 822449256 - (NH) ATLANTIC COAST SURGICAL SUITES LLC | NH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27181 | $4077.00 | 1962663559 - GASTROINTESTINAL ASSOCIATES ENDOSCOPY CENTER, LLC | 262157335 | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27181 | $6365.00 | 1326114869 - EL PASO CENTER FOR GASTROINTESTINAL ENDOSCOPY, LLC | 201482218 - (TX) EL PASO CENTER FOR GASTROINTESTINAL ENDOSCOPY LLC | TX | 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 27181 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 27181 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 27181 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.
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 27181. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 27181 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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