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CPT 27222 Fee Schedule

Last Verified: January 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.

Red Fx-Acetabulum
Key FactDetail
Service Type

Surgery

Surgical Procedures on the Musculoskeletal System

Common Place of Service

21 - Inpatient Hospital

23 - Emergency Room

11 - Office

Common Modifiers

None

RT - Right side of body

LT - Left side of body

Complexity LevelHigh
Medicare Fee ScheduleView Medicare rates for 27222

National average reimbursement for CPT 27222 by major payers:

bcbs

$1,331.42

uhc

$1,311.66

aetna

$1,355.38

cigna

$1,629.31

Preview provider-level rates for...
For billing codeCPT 27222
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 27222

United
27222$174.001912267592 - SURGCENTER AT NATIONAL HARBOR, LLC, HARBORSIDE SURGERY CENTER454110190 - (MD) HARBORSIDE SURGERY CENTERMDAmbulatory Surgical Clinic/Center (261QA1903X)
United
27222$555.001750363461 - BARKLEY SURGICENTER, LLC650428622 - (FL) BARKLEY SURGICENTER LLCFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
27222$225.001275158495 - BCC CHANDLER LLC851284830 - (AZ) BCC CHANDLER LLCAZAmbulatory Surgical Clinic/Center (261QA1903X)
United
27222$135.001285664466 - NEWPORT MULTI SPECIALTY SURGERY CENTER LLC842619042 - (CA) NEWPORT MULTI SPECIALTY SURGERCAAmbulatory Surgical Clinic/Center (261QA1903X)
United
27222$225.001215245238 - AMERICAN ACCESS CARE OF NEW JERSEY, LLC, AZURA SURGERY CENTER CHERRY HILL223783657 - (NJ) AMERICAN ACCESS CARE OF NEW JERSEY LLCNJAmbulatory Surgical Clinic/Center (261QA1903X)
United
27222$963.001861766016 - HAYS SURGERY CENTER, LLC274579547 - (TX) HAYS SURGERY CENTER LLCTXAmbulatory Surgical Clinic/Center (261QA1903X)
United
27222$249.001568244192 - TOWER CLOCK SURGERY CENTER APPLETON, LLC921425291 - (WI) TOWER CLOCK SURGERY CENTER APPLETON LLCWIAmbulatory Surgical Clinic/Center (261QA1903X)
United
27222$506.001245605633 - HARBOR HEIGHTS SURGERY CENTER, LLC473886948 - (MD) HARBOR HEIGHTS SURGERY CENTER LLCMDAmbulatory Surgical Clinic/Center (261QA1903X)
United
27222$515.001760778765 - GASTROINTESTINAL DIAGNOSTIC ENDOSCOPY WOODSTOCK, LLC, TOWN LAKE ENDOSCOPY CENTER274193796 - (GA) GASTROINTESTINAL DIAGNOSTIC ENDOSCOPY WOODSTOCK LLCGAAmbulatory Surgical Clinic/Center (261QA1903X)
United
27222$491.001346205481 - BLOOMINGTON EYE INSTITUTE LLC371361486 - (IL) BLOOMINGTON EYE INSTITUTE LLCILAmbulatory Surgical Clinic/Center (261QA1903X)
United
27222$125.001184819930 - EAST COBB PODIATRY SURGERY CENTER, LLC581486442 - (GA) EAST COBB PODIATRY SURGERY CENTER LLCGAAmbulatory Surgical Clinic/Center (261QA1903X)
United
27222$153.001740491422 - PV PENINSULA PLASTIC SURGERY CENTER208545497 - (CA) PV PENINSULA PLASTIC SURGERY CENTERCAAmbulatory Surgical Clinic/Center (261QA1903X)
United
27222$81.001710931134 - NOVAMED SURGERY CENTER OF JONESBORO, LLC, EYE SURGERY CENTER OF ARKANSAS204407053 - (AR) NOVAMED SURGERY CENTER OF JONESBORO LLCARAmbulatory Surgical Clinic/Center (261QA1903X)
United
27222$197.001033135314 - MED ATLANTIC INC, MED ATLANTIC INC DBA UROSURGICAL CTR OF RICHMOND541759643VAAmbulatory Surgical Clinic/Center (261QA1903X)
United
27222$505.001063427706 - PROHEALTH AMBULATORY SURGERY CENTER INC113447394 - (NY) PROHEALTH AMBULATORY SURGERY CENTER INCNYAmbulatory Surgical Clinic/Center (261QA1903X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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CPT 27222 vs. Other Surgical Procedures on the Musculoskeletal System Codes

The CPT 27222 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 27222 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.

CodeComplexityDescription
27091-CPTHighRemoval Of Hip Prosthesis; Complicated, Including Total Hip Prosthesis, Methylmethacrylate With Or Without Insertion Of Spacer
27125-CPTHighArthroplasty Hip Prosthesis
27134-CPTHighRevis.Tot.Hip Arthropl;Both Compnts
27222-CPTHighRed Fx-Acetabulum

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 27222. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 27222 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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