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See a sample rate comparisonCPT 27403 Fee Schedule
Last Verified: September 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.
Arthrotomy With Open Meniscus Repair
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 21 - Inpatient Hospital 22 - On Campus Outpatient Hospital |
| Common Modifiers | None LT - Left side of body RT - Right side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 27403 |
| Medicaid Fee Schedule | View Medicaid rates for 27403 |
National average reimbursement for CPT 27403 by major payers:
$901.31
$868.66
$914.12
$1,062.54
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CPT 27403
5 of 25 sample ratesHigher to lower in this preview
Indianapolis Endoscopy Center LLP
$7,825.00Published rateRiverside Ambulatory Surgery Center, LLC, The Endoscopy & Colonoscopy Center
Riverside Ambulatory Surgery Center LLC
$3,976.00Published rateMngi Endoscopy Asc Inc
$2,725.00Published rateAsc Gamma Partners Ltd, Miami Surgical Center
Asc Gamma Partners Ltd
$1,325.00Published rateEndosurg Outpatient Center LLC
$550.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 27403 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 27403 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 27403 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 |
|---|---|---|
| 27332-CPT | Moderate | Arthrotomy W/ Xcision Of Semilunar Cartilage (Meniscectomy) Knee, Arthrotomy With Excision Of Semilunar Cartilage (Meniscectomy) Knee; |
| 27333-CPT | Moderate | Arthrotomy W/ Xcision Of Semilunar Cartilage (Meniscectomy) Knee, Arthrotomy With Excision Of Semilunar Cartilage (Meniscectomy) Knee; |
| 27335-CPT | High | Removal Of Knee Joint Lining, Exploration Of Knee Joint. The Procedure Includes Removal Of Inflamed Joint Lining To Alleviate Pain. |
| 27403-CPT | Moderate | Arthrotomy With Open Meniscus Repair |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 27403. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 27403 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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