CPT 27185 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 | • 22 - On Campus Outpatient Hospital • 21 - Inpatient Hospital |
| Common Modifiers | • None • 50 - Bilateral Procedure • LT - Left side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 27185 |
National average reimbursement for CPT 27185 by major payers:

$1,018.76

$945.86

$962.16

$1,182.32
| 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 27185 | ||||||
United | 27185 | $6433.00 | 1689666596 - MENOMONEE FALLS AMBULATORY SURGERY CENTER, LLC | 391745697 - (WI) MENOMONEE FALLS AMBULATORY SURGERY CENTER | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27185 | $3375.00 | 1710112669 - NEWBRIDGE SURGERY CENTER AT WALDORF | 264650579 - (MD) NEWBRIDGE SURGERY CENTER AT WALDORF | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27185 | $3810.00 | 1205871050 - KLAMATH SURGERY CENTER LLC, KLAMATH SURGEONS LLC | 911836091 - (OR) KLAMATH SURGERY CENTER LLC | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27185 | $6588.00 | 1801146535 - SURGCENTER AT PARADISE VALLEY, LLC, SURGCENTER AT PIMA CROSSING | 455364868 - (AZ) SURGCENTER AT PARADISE VALLEY | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27185 | $2788.00 | 1275700957 - PACIFIC CATARACT AND LASER INSTITUTE INC PC | 911394965 - PACIFIC CATARACT AND LASER INSTITUTE, INC., PC | ID | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27185 | $3199.00 | 1932285111 - ORTHOVIRGINIA OPERATORY | 540885859 - (VA) ORTHOVIRGINIA, INC. | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27185 | $1032.00 | 1023103769 - OAK LAWN ENDOSCOPY LLC | 462381028 | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27185 | $5963.00 | 1881225639 - BANNER SURGERY CENTER | 843441285 - (AZ) BANNER SURGERY CENTER | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27185 | $4384.00 | 1891759569 - ST JOSEPH CENTER FOR OUTPATIENT SURGERY, LLC | 680510220 - (MO) ST JOSEPH CENTER FOR OUTPATIENT SURGERY LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27185 | $6365.00 | 1689664906 - PEDIATRIC SURGERY CENTERS, LLC | 201711553 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27185 | $6026.00 | 1245482280 - NORTHWEST AMBULATORY SURGERY CENTER LLC, NORTHWEST AMBULATORY SURGERY CENTER | 263548852 - (OR) NORTHWEST AMBULATORY SURGERY CENTER LLC | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27185 | $902.00 | 1235189739 - ATLANTIC GASTROENTEROLOGY ENDOSCOPY CENTER, PA | 161738362 - (NC) ATLANTIC GASTROENTEROLOGY ENDOSCOPY CENTER PA | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27185 | $1692.00 | 1124443809 - POOLE ENDOSCOPY CENTER, LLC | 521831316 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27185 | $3015.00 | 1841952397 - SOUTHWESTERN OKLAHOMA SURGICAL ASSOCIATES, LLC | 853643949 - (OK) SOUTHWESTERN OKLAHOMA SURGICAL ASSOCIATES LLC | OK | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27185 | $4005.00 | 1720407273 - BRONX SC LLC, EMPIRE STATE AMBULATORY SURGERY CENTER | 273045919 - (NY) BRONX SC LLC DBA EMPIRE STATE AMBULATORY SURGERY CENTER | NY | 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 27185 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 27185 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 27185 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 27185. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 27185 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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