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See a sample rate comparisonCPT 27198 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Clsd Tx Pelvic Ring Fx, Closed Treatment Of Posterior Pelvic Ring Fracture S Dislocation S Diastasis Or Subluxation Of The Ilium Sacroiliac Joint And Or Sacrum With Or Without Anterior Pelvic Ring Fracture S And Or Dislocation S Of The Pubic Symphysis And Or Superior Inferior Rami Unilateral Or Bilateral With Manipulation Requiring More Than Local Anesthesia Ie General Anesthesia Moderate Sedation Spinal Epidural
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 21 - Inpatient Hospital 24 - Ambulatory Surgical Center |
| Common Modifiers | None 51 - Multiple procedures 59 - Distinct Procedural Service |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 27198 |
| Medicaid Fee Schedule | View Medicaid rates for 27198 |
National average reimbursement for CPT 27198 by major payers:
$416.59
$419.63
$428.73
$529.45
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CPT 27198
5 of 25 sample ratesHigher to lower in this preview
Hospital For Special Surgery West Side Ambulatory Surgery Center, LLC, Hss West Side Asc, LLC
$2,159.00Published rateChandler Endoscopy Ambulatory Surgery Center, LLC, Chandler Endoscopy Center
$574.00Published rateOsc LLC, Omaha Surgical Cener
Osc LLC
$250.00Published rateSmartcare Palm Harbor, LLC
Smartcare Palm Harbor LLC
$145.00Published rateWest Annapolis Surgery Center, LLC
West Annapolis Surgery Center LLC
$60.00Published rate
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See a sample payer proposalCPT 27198 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 27198 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 27198 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 |
|---|---|---|
| 27080-CPT | Moderate | Coccygectomy Primary |
| 27197-CPT | Low | Clsd Tx Pelvic Ring Fx, Closed Treatment Of Posterior Pelvic Ring Fracture S Dislocation S Diastasis Or Subluxation Of The Ilium Sacroiliac Joint And Or Sacrum With Or Without Anterior Pelvic Ring Fracture S And Or Dislocation S Of The Pubic Symphysis And Or Superior Inferior Rami Unilateral Or Bilateral Without Manipulation |
| 27198-CPT | Moderate | Clsd Tx Pelvic Ring Fx, Closed Treatment Of Posterior Pelvic Ring Fracture S Dislocation S Diastasis Or Subluxation Of The Ilium Sacroiliac Joint And Or Sacrum With Or Without Anterior Pelvic Ring Fracture S And Or Dislocation S Of The Pubic Symphysis And Or Superior Inferior Rami Unilateral Or Bilateral With Manipulation Requiring More Than Local Anesthesia Ie General Anesthesia Moderate Sedation Spinal Epidural |
| 27218-CPT | High | Treat Pelvic Ring Fracture, Open Treatment Of Posterior Pelvic Bone Fracture And Or Dislocation For Fracture Patterns That Disrupt The Pelvic Ring Unilateral Includes Internal Fixation When Performed Includes Ipsilateral Ilium Sacroiliac Joint And Or Sacrum |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 27198. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 27198 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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