CPT 27355 Fee Schedule
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.
| Key Fact | Detail |
|---|---|
| Service Type | • Surgery • Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | • 22 - On Campus Outpatient Hospital • 24 - Ambulatory Surgical Center |
| Common Modifiers | • None • RT - Right side of body • LT - Left side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 27355 |
National average reimbursement for CPT 27355 by major payers:

$791.47

$817.10

$886.27

$1,025.42
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 27355 | ||||||
United | 27355 | $3500.00 | 1003004482 - SUMMIT AMBULATORY SURGICAL CENTER, LLC | 522148280 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27355 | $1052.81 | 1841570140 - PRASONGCHAI SATTAYAPRASERT | 350593390 - DEACONESS HOSPITAL INC | IN | Clinical Cardiac Electrophysiology Physician (207RC0001X) |
United | 27355 | $708.00 | 1023015989 - TUCSON GASTROENTEROLOGY INSTITUTE, LLC | 860966257 - (AZ) TUCSON GASTROENTEROLOGY INSTITUTE LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27355 | $2393.00 | 1538389812 - IRONBOUND ENDO SURGICAL CENTER, INC. | 223651393 | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27355 | $2260.00 | 1881690949 - ADVANCED AMBULATORY SURGERY CENTER LP | 731675692 - (CA) ADVANCED AMBULATORY SURGERY | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27355 | $3217.00 | 1861931263 - METHODIST CRAIG RANCH SURGERY CENTER LLC | 352583971 - (TX) METHODIST CRAIG RANCH SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27355 | $4339.00 | 1952814386 - ADVANCED SURGICAL CARE OF BOERNE, LLC | 821680961 - (TX) ADVANCED SURGICAL CARE OF BOERNE LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27355 | $8259.00 | 1679998025 - SURGERY CENTER OF KENAI | 462556456 - (AK) SURGERY CENTER OF KENAI | AK | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27355 | $455.00 | 1558372029 - HOLIDAY SURGERY CENTER LIMITED PARTNERSHIP L L P | 593591411 - (FL) HOLIDAY SURGERY CENTER LIMITED PARTNERSHIP L L P | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27355 | $2280.00 | 1730401571 - CHILDRENS SURGERY CENTER LLC, ADVENTHEALTH SURGERY CENTER MAITLAND | 262389638 - (FL) CHILDRENS SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27355 | $2406.00 | 1720001928 - CAMPBELL CLINIC SURGERY CENTER, LLC | 621826300 | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27355 | $8689.00 | 1699445981 - ELKO COMMUNITY HEALTH CENTER, LLC | 851569152 - (NV) ELKO COMMUNITY HEALTH CENTER LLC | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27355 | $1772.00 | 1003062274 - ADVANCED SURGICAL CARE OF BATON ROUGE,LLC | 261476056 - (LA) ADVANCED SURGICAL CARE OF BATON ROUGELLC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27355 | $2800.00 | 1891882031 - GARDEN STATE SURGICAL CENTER, LLC | 223420171 - (NJ) GARDEN STATE SURGICAL CENTER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27355 | $3570.00 | 1144331760 - RESURGENS SURGERY CENTER LLC | 582397841 - (GA) RESURGENS SURGERY CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 27355 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 27355 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 27355 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.
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 27355. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 27355 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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