CPT 27495 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address high-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 | • 21 - Inpatient Hospital • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • LT - Left side of body • RT - Right side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 27495 |
National average reimbursement for CPT 27495 by major payers:
$1,505.80
$1,531.30
$1,622.17
$1,894.39
| 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 27495 | ||||||
United | 27495 | $3719.00 | 1215204128 - MINIMALLY INVASIVE NEUROSPINE AND PAIN INSTITUTE, P.C., ALLSPINE SURGERY CENTER, P.C. | 274395849 - (GA) MINIMALLY INVASIVE NEUROSPINE AND PAIN INSTITUTE PC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27495 | $1118.00 | 1659683662 - PREMIER ENDOSCOPY CENTER, LLC | 272932575 - (AZ) PREMIER ENDOSCOPY CENTER, P.L.L.C. | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27495 | $10360.00 | 1679892913 - BELTWAY SURGERY CENTERS, L.L.C. | 352072586 | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27495 | $5846.00 | 1174185649 - PISA ASC HOLDCO LLC, PAIN INSTITUTE OF SOUTHERN ARIZONA PROCEDURE CENTER | 831944129 - (AZ) PISA ASC HOLDCO LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27495 | $2460.00 | 1952868622 - YORK ENDOSCOPY CENTER LLC | 833765021 | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27495 | $7254.00 | 1023359627 - THE EMORY CLINIC INC., EMORY AESTHETIC CENTER | 582030692 - EMORY UNIVERSITY | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27495 | $2121.00 | 1295798346 - SUNRISE FLAMINGO SURGERY CENTER, LLC, FLAMINGO SURGERY CENTER | 621679326 - (NV) SUNRISE FLAMINGO SURGERY CENTER LLC | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27495 | $3700.00 | 1528572815 - SUN SURGERY CENTER HUNTINGTON LLC | 822382700 - (CA) SUN SURGERY CENTER HUNTINGTON LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27495 | $3041.00 | 1871513705 - SQUAW PEAK SURGICAL FACILITY INC | 860889294 - (AZ) SQUAW PEAK SURGICAL FACILITY INC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27495 | $3118.00 | 1447385158 - HARBIN CLINIC, LLC, HARBIN GI | 582234927 - (GA) THE HARBIN CLINIC, L.L.C. | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27495 | $1604.00 | 1588802987 - NATIONAL PARK ENDOSCOPY CENTER, LLC, SOUTH CENTRAL ENDOSCOPY | 260359982 - (AR) NATIONAL PARK ENDOSCOPY CENTER LLC | AR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27495 | $3565.00 | 1073509733 - WEST PLAINS SURGERY CENTER LLC | 320093110 - (MO) WEST PLAINS AMBULATORY SURGERY CENT | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27495 | $5290.00 | 1699711382 - TOWSON SURGICAL CENTER LLC, TOWSON SURGICAL CENTER | 521945958 - (MD) TOWSON SURGICAL CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27495 | $3335.00 | 1750378295 - BRAINERD LAKES SURGERY CENTER L L C | 200113449 - (MN) BRAINERD LAKES SURGERY CENTER, LLC | MN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27495 | $3452.00 | 1649296807 - SANSUM CLINIC, SANSUM CLINIC ASC | 956419205 - (CA) SANSUM CLINIC | CA | 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 27495 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 27495 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 27495 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 |
|---|---|---|
| 27448-CPT | High | Osteotmy,Femr,Shft/Supracndy;Wo Fix |
| 27450-CPT | High | Osteotomy Femur W Fixation Unilat |
| 27457-CPT | High | Osteotomy, Proximal Tibia, Including Fibular Excision Or Osteotomy (Includes Correction Of Genu Varus (Bowleg) Or Genu Valgus (Knock-Knee)); After Epiphyseal Closure |
| 27495-CPT | High | Prophylactic Treatment Femur |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 27495. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 27495 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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