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See a sample rate comparisonCPT 27385 Fee Schedule
Last Verified: October 2026
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.
Suture Quadriceps Rupture Primary
| 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 27385 |
| Medicaid Fee Schedule | View Medicaid rates for 27385 |
National average reimbursement for CPT 27385 by major payers:
$817.04
$807.85
$866.28
$1,002.04
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CPT 27385
5 of 25 sample ratesHigher to lower in this preview
Newport Bay Surgery Center, LLC
$4,498.00Published rateRye Surgical Center, LLC
Rye Surgical Center LLC
$2,175.00Published rateFlorence Surgery Center, L.P., Florence Surgery Center
Florence Surgery Center Lp
$1,222.00Published rateGastro-Intestinal Center Inc
Gastrointestinal Center Inc
$675.00Published rateDekalb Gastroenterology Associates III, LLC, Dekalb Endoscopy Center
Dekalb Gastroenterology Associates III LLC
$360.00Published rate
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See a sample payer proposalCPT 27385 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 27385 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 27385 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 |
|---|---|---|
| 27380-CPT | Moderate | Suture Tendon Infrapatellar Primary |
| 27381-CPT | High | Surgical Repair Of Knee Tendon, Surgery To Use Stitches To Repair The Main Tendon Behind The Kneecap. The Procedure Involves A Graft Of Tendon Or Connective Tissue. |
| 27385-CPT | Moderate | Suture Quadriceps Rupture Primary |
| 27386-CPT | High | Surgical Repair Of Torn Muscle, Surgery Using Stitches To Repair A Torn Muscle In The Thigh (Hamstring Or Quadriceps). The Procedure Involves A Graft Of Tendon Or Connective Tissue. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 27385. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 27385 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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