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See a sample rate comparisonCPT 27409 Fee Schedule
Medicare rates as of October 2026
CPT 27409 is classified under Surgery, in the Surgical Procedures on the Musculoskeletal System subgroup.
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| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 22On Campus Outpatient Hospital 21Inpatient Hospital |
| Common Modifiers | RTRight side of body LTLeft side of body |
| Hospital Outpatient Group (APC) | APC 5114 - Level 4 Musculoskeletal Procedures |
| Surgery Center Payment (ASC) | A2 - Paid separately, from the OPPS relative weight |
| Common Revenue Codes | 0360 |
| Medicare Fee Schedule | $896.15 national non-facility rate (2026)View Medicare rates for 27409 |
| Medicaid Fee Schedule | $712.945 median of the 8 states in the free previewView Medicaid rates for 27409 |
National average reimbursement for CPT 27409 by major payers:
$1,366.58
BCBS / Anthem
$1,306.06
UnitedHealthcare
$1,324.26
Aetna
$1,584.04
Cigna
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 27409.
CPT 27409
5 of 25 sample ratesHigher to lower in this preview
Ochsner Medical Center, Ochsner Outpatient Surgery Suite
Ochsner Clinic Foundation
$21,412.00Published rateMunster Specialty Surgery Center, LLC, Munster Specialty Surgery Center
Munster Specialty Surgery Center, LLC
$4,472.00Published rateSurgery Center Of Anaheim Hills, LLC
Surgery Center Of Anaheim Hills LLC
$2,500.00Published rateWenatchee Valley Hospital, Confluence Health Omak Asc
Wenatchee Valley Hospital
$1,657.00Published rateSuncoast Endoscopy Asc Lp, Sun Coast Endoscopy Center
Suncoast Endoscopy Asc Lp
$680.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 27409 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The table lists codes related to 27409. 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 27409. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 27409 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 27409 assigned to?
Medicare's hospital outpatient payment system (OPPS) assigns CPT 27409 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 27409 in an ambulatory surgery center?
CMS lists CPT 27409 with ASC payment indicator A2: Paid separately, from the OPPS relative weight.
Which revenue codes are billed with CPT 27409?
Hospital price transparency files list CPT 27409 under these revenue codes: 0360. A revenue code names the hospital department or charge category for the line; it does not change what the service is.