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See a sample rate comparisonCPT 27520 Fee Schedule
Medicare rates as of October 2026
CPT 27520 is classified under Surgery, in the Surgical Procedures on the Musculoskeletal System subgroup.
Closed Treatment Of Patellar F, Closed Treatment Of Patellar Fracture Without Manipulation Closed Treatment Of Patellar Fracture Without Manipulation
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 11Office 23Emergency Room |
| Common Modifiers | LTLeft side of body RTRight side of body |
| Hospital Outpatient Group (APC) | APC 5111 - Level 1 Musculoskeletal Procedures |
| Surgery Center Payment (ASC) | A2 - Paid separately, from the OPPS relative weight |
| Common Revenue Codes | 04500761Sign up to view all 10 |
| Medicare Fee Schedule | $369.75 national non-facility rate (2026)View Medicare rates for 27520 |
| Medicaid Fee Schedule | $294.525 median of the 8 states in the free previewView Medicaid rates for 27520 |
National average reimbursement for CPT 27520 by major payers:
$445.87
BCBS / Anthem
$426.30
UnitedHealthcare
$456.80
Aetna
$529.83
Cigna
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 27520.
CPT 27520
5 of 25 sample ratesHigher to lower in this preview
Quality Surgicenter LLC
$1,500.00Published rateBailey Square Ambulatory Surgical Center, Ltd
Bailey Square Ambulatory Surgical Center Ltd
$627.00Published rateRetina Consultants Surgery Center
$345.00Published rateHighline South Ambulatory Surgery Center, LLC, Highline South Ambulatory Surgery Center
Highline South Ambulatory Surgery Center LLC
$273.00Published rateBay Microsurgical Unit
$86.00Published rate
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See a sample payer proposalCPT 27520 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The table lists codes related to 27520. Select one to see its fee schedule.
| Code | Description |
|---|---|
| 27500-CPT | Closed Treatment Of Femoral Sh, Closed Treatment Of Femoral Shaft Fracture Withoutmanipulation Closed Treatment Of Femoral Shaft Fracture Without |
| 27516-CPT | Closed Treatment Of Distal Fem, Closed Treatment Of Distal Femoral Epiphyseal Separationwithout Manipulation Closed Treatment Of Distal Femoral Epiphyseal Separation |
| 27520-CPT | Closed Treatment Of Patellar F, Closed Treatment Of Patellar Fracture Without Manipulation Closed Treatment Of Patellar Fracture Without Manipulation |
| 27524-CPT | Open Treatment Of Patellar Fra, Open Treatment Of Patellar Fracture With Internalfixation Andor Partial Or Complete Patellectomy And Soft Tissue Repair |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 27520. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 27520 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 27520 assigned to?
Medicare's hospital outpatient payment system (OPPS) assigns CPT 27520 to APC 5111 (Level 1 Musculoskeletal Procedures). An APC groups outpatient services that Medicare pays at the same base rate.
How does Medicare pay for CPT 27520 in an ambulatory surgery center?
CMS lists CPT 27520 with ASC payment indicator A2: Paid separately, from the OPPS relative weight.
Which revenue codes are billed with CPT 27520?
Hospital price transparency files list CPT 27520 under these revenue codes: including 0450, 0761, 0360, 0361 and 0510. A revenue code names the hospital department or charge category for the line; it does not change what the service is.