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See a sample rate comparisonCPT 27558 Fee Schedule
Medicare rates as of October 2026
CPT 27558 is classified under Surgery, in the Surgical Procedures on the Musculoskeletal System subgroup.
Surgery On Dislocated Knee, Surgery To Repair A Dislocated Knee Where There Is Significant Injury To Surrounding Tissue. Pins Or Wires May Be Used To Hold The Joint While It Heals.
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 22On Campus Outpatient Hospital 21Inpatient Hospital |
| Common Modifiers | LTLeft side of body RTRight side of body |
| Hospital Outpatient Group (APC) | APC 5114 - Level 4 Musculoskeletal Procedures |
| Surgery Center Payment (ASC) | J8 - Device-intensive procedure, paid at an adjusted rate |
| Common Revenue Codes | 0360 |
| Medicare Fee Schedule | $1,067.49 national non-facility rate (2026)View Medicare rates for 27558 |
| Medicaid Fee Schedule | $845.695 median of the 8 states in the free previewView Medicaid rates for 27558 |
National average reimbursement for CPT 27558 by major payers:
$1,598.58
BCBS / Anthem
$1,646.15
UnitedHealthcare
$1,640.54
Aetna
$1,953.98
Cigna
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 27558.
CPT 27558
5 of 25 sample ratesHigher to lower in this preview
El Paso Surgery Centers Lp
$10,749.00Published rateChaska Plaza Surgery Center, LLC, Two Twelve Surgery Center
Chaska Plaza Surgery Center LLC
$3,479.00Published rateCampbell Clinic Surgery Center, LLC
$2,928.00Published rateArkansas Renal Group PA, Ouachita Procedure Center
Arkansas Renal Group PA
$1,727.00Published rateEndoscopy Asc Of Middle Georgia LLC
$741.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 27558 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The table lists codes related to 27558. Select one to see its fee schedule.
| Code | Description |
|---|---|
| 27556-CPT | Surgery On Dislocated Knee, Surgery To Repair A Dislocated Knee Where There Is Significant Injury To Surrounding Tissue. Pins Or Wires May Be Used To Hold The Joint While It Heals. |
| 27557-CPT | Surgery On Dislocated Knee, Surgery To Repair A Dislocated Knee Where There Is Significant Injury To Surrounding Tissue. Pins Or Wires May Be Used To Hold The Joint While It Heals. |
| 27558-CPT | Surgery On Dislocated Knee, Surgery To Repair A Dislocated Knee Where There Is Significant Injury To Surrounding Tissue. Pins Or Wires May Be Used To Hold The Joint While It Heals. |
| 27566-CPT | Open Treatment Of Patellar Dis, Open Treatment Of Patellar Dislocation With Or Withoutpartial Or Total Patellectomy Open Treatmentof Patellar Dislocation With Or Without |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 27558. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 27558 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 27558 assigned to?
Medicare's hospital outpatient payment system (OPPS) assigns CPT 27558 to APC 5114 (Level 4 Musculoskeletal Procedures). An APC groups outpatient services that Medicare pays at the same base rate.
How does Medicare pay for CPT 27558 in an ambulatory surgery center?
CMS lists CPT 27558 with ASC payment indicator J8: Device-intensive procedure, paid at an adjusted rate.
Which revenue codes are billed with CPT 27558?
Hospital price transparency files list CPT 27558 under these revenue codes: 0360. A revenue code names the hospital department or charge category for the line; it does not change what the service is.