CPT 27215 Fee Schedule
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.
| 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 • RT - Right side of body • LT - Left side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 27215 |
National average reimbursement for CPT 27215 by major payers:
$861.77
$860.69
$876.85
$1,055.63
| 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 27215 | ||||||
United | 27215 | $410.00 | 1043361587 - CENTER FOR ASSISTED REPRODUCTION LABORATORY AND SURGERY CENTER, INC. | 752829914 - (TX) CENTER FOR ASSISTED REPRODUCTION LABORATORY AND SURGERY CENTER INC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27215 | $375.00 | 1104877976 - VICTOR R. MICHALAK, DBA COSMETIC SURGERY & DERMATOLOGY OF ISSAQUAH, INC. | 911521306 | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27215 | $750.00 | 1558792598 - PARIS SURGERY CENTER, LLC | 461871794 - (TX) PARIS SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27215 | $967.00 | 1093772840 - THE SURGERY CENTER AT JENSEN BEACH, LLC | 651198731 - (FL) THE SURGERY CENTER AT JENSEN B | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27215 | $953.00 | 1790093813 - AZ WEST ENDOSCOPY CENTER LLC | 272343469 - (AZ) AZ WEST ENDOSCOPY CENTER LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27215 | $727.00 | 1619114824 - EAST COLUMBUS SURGERY CENTER LLC | 311641652 - (OH) EAST COLUMBUS SURGERY CENTER LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27215 | $300.00 | 1841347143 - RUXTON SURGICENTER LLC | 522095835 - (MD) RUXTON SURGICENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27215 | $363.00 | 1396700753 - HALCYON LASER & SURGERY CENTER, INC. | 770410936 - (CA) HALCYON LASER SURGERY CENTER INC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27215 | $400.00 | 1033734728 - ORANGE COUNTY SURGICAL CENTER | 851774434 - (CA) ORANGE COUNTY SURGICAL CENTER | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27215 | $351.00 | 1881911451 - SURGERY CENTER OF BJI, LLC | 264737296 - (GA) SURGERY CENTER OF BJI LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27215 | $1100.00 | 1295848752 - ESSEX SURGICAL ARTS SURGERY CENTER, LLC, MOBILE VASCULAR PHYSICIANS | 202242123 - (NJ) ESSEX SURGICAL ARTS SURGERY | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27215 | $1408.00 | 1063641801 - PRESBYTERIAN SAMEDAY SURGERY CENTER AT HUNTERSVILLE LLC, NOVANT HEALTH HUNTERSVILLE OUTPATIENT SURGERY | 262422926 - (NC) PRESBYTERIAN SAMEDAY SURGERY CENTER AT HUNTERSVILLE LLC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27215 | $523.00 | 1386999662 - PALOS HILLS SURGERY CENTER, LLC | 451617538 - (IL) PALOS HILLS SURGERY CENTER LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27215 | $1158.00 | 1447797105 - SOUTH DENVER MUSCULOSKELETAL SURGICAL PARTNERS, LLC, SOUTH DENVER SURGERY CENTER | 364821257 - (CO) SOUTH DENVER MUSCULOSKELETAL SURGICAL PARTNERS LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27215 | $225.00 | 1891951885 - MISSISSIPPI EYE SURGERY CENTER, MISSISSIPPI EYE SURGERY CENTER FACILITY | 770619942 | MS | 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 27215 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 27215 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 27215 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 |
|---|---|---|
| 27198-CPT | Moderate | Closed Treatment Of Posterior Pelvic Ring Frac- Ture(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 Bila- Teral Without Manipulation |
| 27202-CPT | Moderate | Open Treatment Coccygeal Fracture |
| 27215-CPT | Moderate | Open Treatment Of Iliac Spine(S), Tuberosity Avulsion, Or Iliac Wing Fracture(S), Unilateral, For Pelvic Bone Fracture Patterns That Do Not Disrupt The Pelvic Ring, Includes Internal Fixation, When Performed |
| 27216-CPT | High | Percutaneous Skeletal Fixation Of Posterior Pelvic Bone Fracture And/Or Dislocation, For Fracture Patterns That Disrupt The Pelvic Ring, Unilateral (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 27215. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 27215 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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