CPT 27356 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 • LT - Left side of body • RT - Right side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 27356 |
National average reimbursement for CPT 27356 by major payers:
$974.11
$996.59
$1,067.99
$1,250.80
| 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 27356 | ||||||
United | 27356 | $1763.00 | 1053632372 - ORTHOATLANTA SURGERY CENTER OF AUSTELL, LLC | 272363967 - (GA) ORTHOATLANTA SURGERY CENTER OF AUSTELL LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27356 | $1100.00 | 1649790171 - ATHENS SPINE PROCEDURAL CENTER LLC | 364870744 - (GA) ATHENS SPINE PROCEDURAL CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27356 | $1100.00 | 1508846411 - FIRST STATE SURGERY CENTER, LLC | 510402966 - (DE) FIRST STATE SURGERY CENTER LLC | DE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27356 | $1387.00 | 1982105458 - HEART CARE CENTER, LLC | 824195385 | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27356 | $1505.00 | 1740287168 - AFFILIATED PHYSICIANS & SURGEONS, LTD | 860495569 - (AZ) AFFILIATED PHYSICIANS SURGEONS LTD | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27356 | $6904.00 | 1083644124 - MEMORIAL HERMANN SURGERY CENTER SOUTHWEST LLP, MEMORIAL HERMANN SURGERY CENTER SOUTHWEST | 202866884 - (TX) MEMORIAL HERMANN SURGERY CENTER SOUTHWEST LLP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27356 | $1519.00 | 1629409578 - PAIN CENTER OF WYOMING VALLEY, LLC | 462023592 - (PA) PAIN CENTER OF WYOMING VALLEY LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27356 | $1200.00 | 1043205040 - ST LUKES SURGICAL CENTER INC | 592407224 - (FL) ST LUKES SURGICAL CENTER INC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27356 | $2490.00 | 1881225639 - BANNER SURGERY CENTER | 843441285 - (AZ) BANNER SURGERY CENTER | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27356 | $751.00 | 1770557233 - MESA AZ ENDOSCOPY ASC LLC, DESERT ENDOSCOPY CENTER | 510426858 - (AZ) THE MESA AZ ENDOSCOPY ASC, LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27356 | $10081.00 | 1588618557 - COLUMBIA MEDICAL CENTER OF PLANO SUBSIDIARY LP, MEDICAL CITY PLANO | 621682203 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27356 | $1690.00 | 1750663084 - PNW EYE PLLC, PACIFIC NORTHWEST EYE SURGERY CENTER | 453155522 - (WA) PNW EYE, PLLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27356 | $3347.00 | 1366935074 - SKYWAY SURGERY CENTER, LLC | 813237016 - (FL) SKYWAY SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27356 | $2799.00 | 1174185649 - PISA ASC HOLDCO LLC, PAIN INSTITUTE OF SOUTHERN ARIZONA PROCEDURE CENTER | 831944129 - (AZ) PISA ASC HOLDCO LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27356 | $2080.00 | 1477905271 - KATY ASC, LP, ADVANCED CARDIOVASCULAR & SURGERY CENTER AT METHODIST WEST HOUSTON | 813141435 | TX | 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 27356 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 27356 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 27356 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 |
|---|---|---|
| 27355-CPT | Moderate | Exc Lesion Femur |
| 27356-CPT | Moderate | Exc/Curet-Cyst/Tumor-Femur;Autogrft |
| 27357-CPT | High | Excis/Curet Bone Cyst/Ben.Tumor-Femur;W/ |
| 27358-CPT | Moderate | Excision Or Curettage Of Bone Cyst Or Benign Tumor Of Femur; With Internal Fixation (List In Addition To Code For Primary Procedure) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 27356. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 27356 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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