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See a sample rate comparisonCPT 27256 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.
Treatment Of Spontaneous Hip, Treatment Of Spontaneous Hip Dislocation (Developmentalincluding Congenital Or Pathological) By Abduction Splint Or Traction Without Anesthesia Without Manipulation
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 11 - Office 22 - On Campus Outpatient Hospital |
| Common Modifiers | None LT - Left side of body 50 - Bilateral Procedure |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 27256 |
| Medicaid Fee Schedule | View Medicaid rates for 27256 |
National average reimbursement for CPT 27256 by major payers:
$404.10
$406.80
$424.44
$402.87
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CPT 27256
5 of 25 sample ratesHigher to lower in this preview
Iu Health Southwest Fort Wayne Ambulatory Surgery Center LLC, Iu Health Surgery Center Fort Wayne
Iu Health Southwest Fort Wayne Ambulatory Surgery Center LLC
$4,613.00Published rateJessica Mendel
Deaconess Hospital Inc
$533.53Published rateOsc LLC, Omaha Surgical Cener
Osc LLC
$250.00Published rateOakland Ca Endoscopy Asc Lp, East Bay Endosurgery Center
Oakland Ca Endoscopy Asc Lp
$169.00Published rateIntegris Ddsi Endoscopy Centers LLC
$67.00Published rate
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See a sample payer proposalCPT 27256 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 27256 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 27256 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 |
|---|---|---|
| 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 |
| 27256-CPT | Moderate | Treatment Of Spontaneous Hip, Treatment Of Spontaneous Hip Dislocation (Developmentalincluding Congenital Or Pathological) By Abduction Splint Or Traction Without Anesthesia Without Manipulation |
| 27257-CPT | Moderate | Treatment Of Spontaneous Hip, Treatment Of Spontaneous Hip Dislocation (Developmentalincluding Congenital Or Pathological) By Abduction Splint Or Traction With Manipulationrequiring Anesthesia |
| 27258-CPT | High | Treat Hip Dislocation, Open Treatment Of Spontaneous Hip Dislocation Developmental Including Congenital Or Pathological Replacement Of Femoral Head In Acetabulum Including Tenotomy Etc |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 27256. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 27256 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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