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CPT 27535 Fee Schedule

Last Verified: January 2026

Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.

Open Tx Tib Fx Unicondy W/Wo Fix
Key FactDetail
Service Type

Surgery

Surgical Procedures on the Musculoskeletal System

Common Place of Service

21 - Inpatient Hospital

22 - On Campus Outpatient Hospital

Common Modifiers

None

LT - Left side of body

RT - Right side of body

Complexity LevelHigh

National average reimbursement for CPT 27535 by major payers:

bcbs

$1,159.44

uhc

$1,220.30

aetna

$1,296.46

cigna

$1,501.64

Preview provider-level rates for...
For billing codeCPT 27535
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 27535

United
27535$2552.001942414750 - HAMILTON EYE INSTITUTE SURGERY CENTER, L.P.202873438 - (TN) HAMILTON EYE INSTITUTE SURGERY CENTER LPTNAmbulatory Surgical Clinic/Center (261QA1903X)
United
27535$6286.001992708929 - NOVAMED MANAGEMENT SERVICES LLC, ATLANTA EYE SURGERY CENTER364013255 - NOVAMED, INC.GAAmbulatory Surgical Clinic/Center (261QA1903X)
United
27535$1400.001588029870 - PACIFIC GASTROENTEROLOGY PLLC201377401 - (WA) PACIFIC GASTROENTEROLOGY, PLLCWAAmbulatory Surgical Clinic/Center (261QA1903X)
United
27535$2790.001609965961 - BROOKINGS AMBULATORY SURGERY CENTER, LLP203272258 - (SD) BROOKINGS AMBULATORY SURGERY CENTER LLPSDAmbulatory Surgical Clinic/Center (261QA1903X)
United
27535$732.001538157037 - WEST CENTRAL SURGICAL CENTER, LLC200088459 - (OH) WEST CENTRAL SURGICAL CENTER LLCOHAmbulatory Surgical Clinic/Center (261QA1903X)
United
27535$2413.001518450790 - VIRGINIA ENT SURGERY CENTER INC541052755 - (VA) VIRGINIA EAR, NOSE & THROAT ASSOCIATES, P.C.VAAmbulatory Surgical Clinic/Center (261QA1903X)
United
27535$4475.001548280209 - SHORT HILLS SURGERY CENTER, LLC, SHORT HILLS SURGERY CENTER721572665 - (NJ) SHORT HILLS SURGERY CENTER, LLCNJAmbulatory Surgical Clinic/Center (261QA1903X)
United
27535$390.001982696894 - AFFILIATED AMBULATORY SURGERY CENTER LLC311719268 - (OH) AFFILIATED AMBULATORY SURGERY CENTER, LLCOHAmbulatory Surgical Clinic/Center (261QA1903X)
United
27535$1028.001083124366 - KENTUCKIANA PAIN SPECIALIST AMBULATORY SURGERY CENTER, KPS AMBULATORY SURGERY CENTER823254465 - (KY) KENTUCKIANA PAIN SPECIALIST AMBULATORY SURGERY CENTERKYAmbulatory Surgical Clinic/Center (261QA1903X)
United
27535$1828.001477503175 - PALMS WEST SURGERY CENTER LTD201008459 - (FL) PALMS WEST SURGERY CENTER LTDFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
27535$1500.001609269232 - SURGICAL CENTER OF PONTE VEDRA BEACH LLC, PONTE VEDRA BEACH SURGERY CENTER472133947 - (FL) SURGICAL CENTER OF PONTE VEDRA BFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
27535$5354.001245820042 - ALOE SURGICAL CENTER SCOTTSDALE, LLC845112576 - (AZ) ALOE SURGICAL CENTER SCOTTSDALE LLCAZAmbulatory Surgical Clinic/Center (261QA1903X)
United
27535$765.001063512945 - TIFTON ENDOSCOPY CENTER, INC.582195460GAAmbulatory Surgical Clinic/Center (261QA1903X)
United
27535$2075.001689652638 - INSTITUTE OF ORTHOPAEDIC SURGERY LLC731657293 - (NV) INSTITUTE OF ORTHOPAEDIC SURGERY LLCNVAmbulatory Surgical Clinic/Center (261QA1903X)
United
27535$1579.001376518357 - ORLANDO FL ENDOSCOPY ASC LLC, CITRUS AMBULATORY SURGERY CENTER202873015 - ORLANDO FL ENDOSCOPY ASC LLCFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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CPT 27535 vs. Other Surgical Procedures on the Musculoskeletal System Codes

The CPT 27535 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 27535 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.

CodeComplexityDescription
27507-CPTHighOpen Tx Fem Fx W/Plate W/Wo Cerclg
27530-CPTModerateClo Tx Tib Fx Proximal Wo Manip
27532-CPTModerateRed Fx-Tibia Proximal
27535-CPTHighOpen Tx Tib Fx Unicondy W/Wo Fix

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 27535. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 27535 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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