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See a sample rate comparisonHealthcare 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 | 24 - Ambulatory Surgical Center 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 27305 |
| Medicaid Fee Schedule | View Medicaid rates for 27305 |
National average reimbursement for CPT 27305 by major payers:

$671.72

$645.11

$662.11

$794.52
Choose a payer to see a sample of rates for CPT 27305.
Indiana University Health Arnett Inc
Rancho Mirage Surgery Center, LLC
Progressive Surgical Institute Inc
Deaconess Hospital Inc
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Rate Benchmarking
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonPayer Contract Negotiation
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 27305 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 27305 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 27305 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 |
|---|---|---|
| 27301-CPT | Moderate | Ncision & Drain Deep Absces Bursa Or Hematom Thigh/ Knee, Incision And Drainage Deep Abscess Bursa Or Hematoma Thigh Or Knee |
| 27303-CPT | Moderate | Ncision Deep W/ Open Of Bone Cortex Femur Or Knee (Eg Osteom, Incision Deep With Opening Of Bone Cortex Femur Or Knee (Eg Osteom |
| 27305-CPT | Moderate | Relieve Tension In Upper Leg, Surgery To Cut Fascia (Strong Connective Tissue That Surrounds Muscle Bone And Organs) In Hip Or Thigh To Relieve Tension Or Pressure. |
| 27306-CPT | Moderate | Tenotomy Percutane Adductor Or Hmstring; Sngle Tndon (Sepa, Tenotomy Percutaneous Adductor Or Hamstring; Single Tendon (Separate |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 27305. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 27305 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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