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See a sample rate comparisonCPT 27516 Fee Schedule
Last Verified: September 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.
Closed Treatment Of Distal Fem, Closed Treatment Of Distal Femoral Epiphyseal Separationwithout Manipulation Closed Treatment Of Distal Femoral Epiphyseal Separation
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 11 - Office 22 - On Campus Outpatient Hospital 21 - Inpatient Hospital |
| Common Modifiers | None RT - Right side of body LT - Left side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 27516 |
| Medicaid Fee Schedule | View Medicaid rates for 27516 |
National average reimbursement for CPT 27516 by major payers:
$688.30
$677.09
$703.98
$793.05
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CPT 27516
5 of 25 sample ratesHigher to lower in this preview
Memorial Hermann Surgery Center Memorial City LLC, Memorial Hermann Memorial Village Surgery Center
$1,831.00Published rateA Center For Foot And Ankle Surgery PA, The Center For Special Surgery Of Hawthorne
A Center For Foot And Ankle Su
$857.00Published rateMile High Surgicenter, LLC
$395.00Published rateWestmont Surgery Center LLC, Salt Creek Surgery Center
Westmont Surgery Center, LLC Dba Salt Creek Surgery Center
$244.00Published rateTaylor Surgery Center, LLC, Surgical Arts Surgery Center
Taylor Surgery Center LLC
$45.00Published rate
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See a sample payer proposalCPT 27516 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 27516 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 27516 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 |
|---|---|---|
| 27510-CPT | Moderate | Closed Treatment Of Femoral Fr, Closed Treatment Of Femoral Fracture Distal End Medial Or Lateral Condyle With Manipulation Closed Treatment Of Femoral Fracture Distal End Medial Or |
| 27511-CPT | High | Open Treatment Of Femoral Supr, Open Treatment Of Femoral Supracondylar Or Transcondylar Fracture Without Intercondylar Extension Includes Internal Fixation When Performed |
| 27516-CPT | Moderate | Closed Treatment Of Distal Fem, Closed Treatment Of Distal Femoral Epiphyseal Separationwithout Manipulation Closed Treatment Of Distal Femoral Epiphyseal Separation |
| 27519-CPT | High | Surgery To Repair Broken Knee, Surgery To Repair Broken Knee Bones (Femoral Epiphyseal Separation). Pins Wires Or Screws May Be Used To Hold The Bones In Place. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 27516. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 27516 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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