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See a sample rate comparisonCPT 27496 Fee Schedule
Last Verified: October 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.
Surgery On Thigh Or Knee, Surgery To Cut The Connective Tissue In The Thigh Or Knee. The Procedure May Involve Removal Of Tissue Damaged By Buildup Of Pressure From Swelling (Compartment Syndrome).
| 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 RT - Right side of body LT - Left side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 27496 |
| Medicaid Fee Schedule | View Medicaid rates for 27496 |
National average reimbursement for CPT 27496 by major payers:
$727.80
$718.55
$744.83
$892.23
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CPT 27496
5 of 25 sample ratesHigher to lower in this preview
Memorial Hermann Surgery Center Sugar Land LLP
$7,838.00Published rateSummit Ambulatory Surgical Center, LLC
$3,623.00Published rateValley View Surgical Center
$2,600.00Published rateThe Waldorf Endoscopy Asc, LLC, Waldorf Endoscopy Center
The Waldorf Endoscopy Asc LLC
$1,746.00Published ratePuget Sound Gastroenterology, PLLC, Fremont Endoscopy Center
Puget Sound Gastroenterology, P.S.
$753.00Published rate
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See a sample payer proposalCPT 27496 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 27496 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 27496 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 |
|---|---|---|
| 27466-CPT | High | Osteoplasty, Femur; Lengthening |
| 27477-CPT | Moderate | Arrest Epiphyseal Any Mthod (Eg Epiphysiodes); Tibia & Fibula, Arrest Epiphyseal Any Method (Eg Epiphysiodesis); Tibia And Fibula |
| 27496-CPT | Moderate | Surgery On Thigh Or Knee, Surgery To Cut The Connective Tissue In The Thigh Or Knee. The Procedure May Involve Removal Of Tissue Damaged By Buildup Of Pressure From Swelling (Compartment Syndrome). |
| 27498-CPT | Moderate | Surgery On Thigh Or Knee, Surgery To Cut The Connective Tissue In The Thigh Or Knee. The Procedure May Involve Removal Of Tissue Damaged By Buildup Of Pressure From Swelling (Compartment Syndrome). |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 27496. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 27496 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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