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See a sample rate comparisonCPT 27407 Fee Schedule
Medicare rates as of October 2026
CPT 27407 is classified under Surgery, in the Surgical Procedures on the Musculoskeletal System subgroup.
Suture Cruciate Ligament Knee Prim
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 22On Campus Outpatient Hospital 24Ambulatory Surgical Center |
| Common Modifiers | RTRight side of body LTLeft side of body |
| Hospital Outpatient Group (APC) | APC 5114 - Level 4 Musculoskeletal Procedures |
| Surgery Center Payment (ASC) | J8 - Device-intensive procedure, paid at an adjusted rate |
| Common Revenue Codes | 03600960 |
| Medicare Fee Schedule | $748.18 national non-facility rate (2026)View Medicare rates for 27407 |
| Medicaid Fee Schedule | $596.295 median of the 8 states in the free previewView Medicaid rates for 27407 |
National average reimbursement for CPT 27407 by major payers:
$1,058.45
BCBS / Anthem
$1,065.32
UnitedHealthcare
$1,088.51
Aetna
$1,301.89
Cigna
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Choose a payer to see a sample of rates for CPT 27407.
CPT 27407
5 of 25 sample ratesHigher to lower in this preview
Surgery Affiliate Of El Paso, LLC, Foundation Surgery Affiliate Of El Paso, LLC
Surgery Affiliate Of El Paso LLC
$18,079.00Published ratePotomac View Surgery Center, LLC
Potomac View Surgery Center LLC
$6,365.00Published ratePediatric And Adult Surgery Center Of Atlanta LLC
$3,844.00Published rateSouthwest Surgery Center LLC
$2,400.00Published rateAdvanced Eye Surgery Center, L.L.C.
Advanced Eye Surgery Center LLC
$819.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 27407 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The table lists codes related to 27407. Select one to see its fee schedule.
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 27407. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 27407 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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Frequently Asked Questions
What APC is CPT 27407 assigned to?
Medicare's hospital outpatient payment system (OPPS) assigns CPT 27407 to APC 5114 (Level 4 Musculoskeletal Procedures). An APC groups outpatient services that Medicare pays at the same base rate.
How does Medicare pay for CPT 27407 in an ambulatory surgery center?
CMS lists CPT 27407 with ASC payment indicator J8: Device-intensive procedure, paid at an adjusted rate.
Which revenue codes are billed with CPT 27407?
Hospital price transparency files list CPT 27407 under these revenue codes: 0360 and 0960. A revenue code names the hospital department or charge category for the line; it does not change what the service is.