CPT 27358 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 • 21 - Inpatient Hospital |
| Common Modifiers | • None • LT - Left side of body • RT - Right side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 27358 |
National average reimbursement for CPT 27358 by major payers:
$415.02
$384.10
$395.87
$463.52
| 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 27358 | ||||||
United | 27358 | $99.00 | 1114177417 - NISENFELD & CHILTON, MD PA, ORTHOPAEDIC ASSOCIATES OF FREDERICK, ASC | 521135399 - (MD) NISENFELD & CHILTON, M.D., P.A. | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27358 | $566.00 | 1295060069 - TIMONIUM SURGERY CENTER, LLC | 270399689 - (MD) TIMONIUM SURGERY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27358 | $1708.00 | 1184752305 - SEASHORE SURGICAL INSTITUTE, LLC | 223660141 - (NJ) SEASHORE SURGICAL INSTITUTE | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27358 | $574.00 | 1922611714 - COLORADO UROLOGIC SURGERY CENTER LLC | 851926897 - (CO) COLORADO UROLOGIC SURGERY CENTER LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27358 | $390.00 | 1366681355 - SALINA SURGICAL ARTS CENTER, LLC, DAVID A. HENDRICK M.D., P.A. | 208824691 - (KS) DAVID A. HENDRICK MD | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27358 | $531.00 | 1720085277 - ROSWELL SURGERY CENTER LLC, ROSWELL SURGERY CENTER | 582577112 - (GA) ROSWELL SURGERY CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27358 | $688.00 | 1316947609 - AMARILLO ENDOSCOPY CENTER, LP | 752893120 - (TX) AMARILLO ENDOSCOPY CENTER LP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27358 | $301.00 | 1508135658 - SURGERY CENTER OF ATHENS LLC | 450581955 - (GA) SURGERY CENTER OF ATHENS LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27358 | $200.00 | 1962668319 - BOULDER MEDICAL CENTER, PC, BOULDER MEDICAL CENTER ASC | 840834835 - BOULDER MEDICAL CENTER, P.C. | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27358 | $140.00 | 1619517539 - MOUNTAIN WEST DERM | 813253496 | ID | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27358 | $275.00 | 1780610576 - FINDLAY SURGERY CENTER LTD | 870620245 - (OH) FINDLAY SURGERY CENTER, LTD | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27358 | $560.00 | 1346624665 - WESTGREEN SURGICAL CENTER LLC, HOUSTON ORTHOPEDIC & SPINE SURGERY CENTER | 474468184 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27358 | $40.00 | 1386004018 - COPPEL SURGICAL SOLUTIONS, NEVADA SURGICAL SUITES | 460641933 - (NV) COPPEL SURGICAL SOLUTIONS | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27358 | $227.00 | 1922187103 - NORTH HILLS SURGERY CENTER, LLC, NORTH HILLS SURGERY CENTER | 710807771 - (AR) NORTH HILLS SURGERY CENTER LLC | AR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27358 | $114.00 | 1144219908 - HSC SURGICAL ASSOCIATES OF CINCINNATI, LLC, TRI STATE ENDOSCOPY CENTER | 311386408 - (OH) HSC SURGICAL ASSOCIATES OF CINCINNATI, LLC | OH | 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 27358 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 27358 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 27358 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 27358. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 27358 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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