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See a sample rate comparisonCPT 27495 Fee Schedule
CPT 27495 is classified under Surgery, in the Surgical Procedures on the Musculoskeletal System subgroup.
Secure Bone To Prevent Break, Treatment To Prevent A Broken Bone In Leg. The Bone Which Is Already Weakened Is Stabilized With A Pin Plate Nail Or Wire.
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 21Inpatient Hospital 22On Campus Outpatient Hospital |
| Common Modifiers | LTLeft side of body RTRight 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 | 0360 |
| Medicare Fee Schedule | View Medicare rates for 27495 |
| Medicaid Fee Schedule | $866.92 median of the 8 states in the free previewView Medicaid rates for 27495 |
National average reimbursement for CPT 27495 by major payers:
$1,505.80
BCBS / Anthem
$1,531.30
UnitedHealthcare
$1,622.17
Aetna
$1,851.32
Cigna
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 27495.
CPT 27495
5 of 25 sample ratesHigher to lower in this preview
Texas Health Harris Methodist Hospital Stephenville
$20,777.00Published rateSurgery Center Of Bay Area Houston, LLC
$5,758.00Published rateWest Plains Surgery Center LLC
West Plains Ambulatory Surgery Cent
$3,565.00Published rateYork Endoscopy Center LLC
$2,460.00Published ratePremier Endoscopy Center, LLC
Premier Endoscopy Center, P.L.L.C.
$1,118.00Published rate
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See a sample payer proposalCPT 27495 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The table lists codes related to 27495. Select one to see its fee schedule.
| Code | Description |
|---|---|
| 27448-CPT | Osteotmy,Femr,Shft/Supracndy;Wo Fix |
| 27450-CPT | Osteotomy Femur W Fixation Unilat |
| 27457-CPT | Knee/Leg Surgery, Osteotomy Proximal Tibia Including Fibular Excision Or Osteotomy (Includes Correction Of Genu Varus (Bowleg) Or Genu Valgus (Knock-Knee)) Unilateral; After Epiphyseal Closure |
| 27495-CPT | Secure Bone To Prevent Break, Treatment To Prevent A Broken Bone In Leg. The Bone Which Is Already Weakened Is Stabilized With A Pin Plate Nail Or Wire. |
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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Frequently Asked Questions
What APC is CPT 27495 assigned to?
Medicare's hospital outpatient payment system (OPPS) assigns CPT 27495 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 27495 in an ambulatory surgery center?
CMS lists CPT 27495 with ASC payment indicator J8: Device-intensive procedure, paid at an adjusted rate.
Which revenue codes are billed with CPT 27495?
Hospital price transparency files list CPT 27495 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.