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See a sample rate comparisonCPT 27530 Fee Schedule
Medicare rates as of October 2026
CPT 27530 is classified under Surgery, in the Surgical Procedures on the Musculoskeletal System subgroup.
Closed Treatment Of Tibial Fra, Closed Treatment Of Tibial Fracture Proximal (Plateau)Without Manipulation Closed Treatment Of Tibial Fracture Proximal (Plateau)
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 11Office 23Emergency Room 21Inpatient Hospital |
| 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 | $349.04 national non-facility rate (2026)View Medicare rates for 27530 |
| Medicaid Fee Schedule | $284.09 median of the 8 states in the free previewView Medicaid rates for 27530 |
National average reimbursement for CPT 27530 by major payers:
$458.44
BCBS / Anthem
$432.19
UnitedHealthcare
$470.68
Aetna
$524.91
Cigna
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 27530.
CPT 27530
5 of 25 sample ratesHigher to lower in this preview
Prospect Ccmc, LLC
$1,957.00Published rateCapitol Surgical Center LLC
$566.00Published rateElmhurst Outpatient Surgery Center LLC
Elmhurst Outpatient Surgery Center, LLC
$255.00Published rateWest Michigan Surgery Center, LLC
Michigan Primary Care Partners PC
$179.00Published rateAllegany Ambulatory Surgery Center LLC
$52.00Published rate
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See a sample payer proposalCPT 27530 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The table lists codes related to 27530. Select one to see its fee schedule.
| Code | Description |
|---|---|
| 27524-CPT | Open Treatment Of Patellar Fra, Open Treatment Of Patellar Fracture With Internalfixation Andor Partial Or Complete Patellectomy And Soft Tissue Repair |
| 27530-CPT | Closed Treatment Of Tibial Fra, Closed Treatment Of Tibial Fracture Proximal (Plateau)Without Manipulation Closed Treatment Of Tibial Fracture Proximal (Plateau) |
| 27532-CPT | Closed Treatment Of Tibial Fra, Closed Treatment Of Tibial Fracture Proximal (Plateau)With Or Without Manipulation With Skeletal Traction Closed Treatment Of Tibial Fracture Proximal (Plateau) |
| 27535-CPT | Surgical Repair Of Broken Leg, Surgery To Repair A Broken Leg Bone (Tibia). Pins Plates Wires Or Screw May Be Used To Stabilize The Broken Bone. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 27530. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 27530 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 27530 assigned to?
Medicare's hospital outpatient payment system (OPPS) assigns CPT 27530 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 27530 in an ambulatory surgery center?
CMS lists CPT 27530 with ASC payment indicator A2: Paid separately, from the OPPS relative weight.
Which revenue codes are billed with CPT 27530?
Hospital price transparency files list CPT 27530 under these revenue codes: including 0450, 0761, 0360, 0510 and 0361. A revenue code names the hospital department or charge category for the line; it does not change what the service is.