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See a sample rate comparisonCPT 27259 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.
Treat Hip Dislocation, Open Treatment Of Spontaneous Hip Dislocation Developmental Including Congenital Or Pathological Replacement Of Femoral Head In Acetabulum Including Tenotomy Etc With Femoral Shaft Shortening
| 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 LT - Left side of body RT - Right side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 27259 |
| Medicaid Fee Schedule | View Medicaid rates for 27259 |
National average reimbursement for CPT 27259 by major payers:
$1,946.97
$2,090.83
$2,131.51
$2,515.00
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CPT 27259
5 of 25 sample ratesHigher to lower in this preview
Centracare Surgery Center, LLC
$4,890.00Published rateSouthwest Washington Regional Surgery Center, LLC
Southwest Washington Regional Surgery Center
$2,942.00Published rateDermatology Associates Of Kentucky, Psc
New Lexington Clinic, P.S.C.
$2,074.00Published rateBattle Street Surgery Center, LLC
Battle Street Surgery Center LLC
$1,623.00Published rateAnderson Endoscopy Center LLC
$597.00Published rate
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See a sample payer proposalCPT 27259 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 27259 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 27259 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 |
| 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 |
| 27259-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 With Femoral Shaft Shortening |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 27259. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 27259 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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