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See a sample rate comparisonCPT 27254 Fee Schedule
Last Verified: October 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.
Open Treatment Of Hip Dislocat, Open Treatment Of Hip Dislocation Traumatic Withacetabular Wall And Femoral Head Fracture With Orwithout Internal Or External Fixation
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 21 - Inpatient Hospital 22 - On Campus Outpatient Hospital 24 - Ambulatory Surgical Center 23 - Emergency Room |
| Common Modifiers | None LT - Left side of body RT - Right side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 27254 |
| Medicaid Fee Schedule | View Medicaid rates for 27254 |
National average reimbursement for CPT 27254 by major payers:
$1,811.01
$1,721.75
$1,717.98
$2,075.13
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CPT 27254
5 of 25 sample ratesHigher to lower in this preview
Memorial Hermann Surgery Center Woodlands Parkway, LLC, Memorial Hermann Surgery Center Woodlands Parkway
$7,838.00Published rateManchester Surgery Center, LLC
$3,570.00Published rateBangor Eye Surgery, PA
Bangor Eye Surgery PA
$2,250.00Published rateJohns Hopkins Surgery Centers Series, Green Spring Station Surgery Center
Johns Hopkins Surgery Center Series
$1,685.00Published ratePrinceton Eye Group PA, Eye Surgery Princeton
Princeton Eye Group
$654.00Published rate
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See a sample payer proposalCPT 27254 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 27254 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 27254 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 |
|---|---|---|
| 27227-CPT | High | Open Treatment Of Acetabular F, Open Treatment Of Acetabular Fracture(S) Involvinganterior Or Posterior (One) Column Or A Fracture Running Transversely Across The Acetabulum With Internal Fixation |
| 27228-CPT | High | Treat Hip Fracture S, Open Treatment Of Acetabular Fracture S Involving Anterior And Posterior Two Columns Includes T Fracture And Both Column Fracture With Complete Articular Detachment Or Single Column Or Transverse Fracture With Associated Acetabular Wall Fracture With Internal Fixation |
| 27250-CPT | Moderate | Closed Treatment Of Hip Disloc, Closed Treatment Of Hip Dislocation Traumatic Withoutanesthesia Closed Treatment Of Hip Dislocation Traumatic Without |
| 27254-CPT | High | Open Treatment Of Hip Dislocat, Open Treatment Of Hip Dislocation Traumatic Withacetabular Wall And Femoral Head Fracture With Orwithout Internal Or External Fixation |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 27254. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 27254 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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