CPT 27560 Fee Schedule
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.
| Key Fact | Detail |
|---|---|
| Service Type | • Surgery • Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | • 23 - Emergency Room • 11 - Office |
| Common Modifiers | • None • 54 - Surgical Care Only • LT - Left side of body |
| Complexity Level | Moderate |
National average reimbursement for CPT 27560 by major payers:
$509.98
$490.17
$541.40
$621.97
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 27560 | ||||||
United | 27560 | $1005.00 | 1528438884 - MCLEAN AMBULATORY SURGERY, LLC | 474966649 - (VA) MCLEAN AMBULATORY SURGERY LLC | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27560 | $88.00 | 1487239059 - AAU GREENBELT ASC LLC | 862166420 - (MD) AAU GREENBELT ASC LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27560 | $723.00 | 1174852461 - MAYFIELD SPINE SURGERY CENTER LLC, MAYFIELD SPINE SURGERY CENTER | 271482322 | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27560 | $300.00 | 1174005235 - IDAHO FALLS ASC | 823089090 - (ID) IDAHO FALLS ASC | ID | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27560 | $79.00 | 1538692876 - CHICAGO VASCULAR ASC LLC | 815103001 - (IL) CHICAGO VASCULAR ASC LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27560 | $200.00 | 1376194431 - ASCENT SURGERY CENTER LLC | 823347568 - (TX) ASCENT SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27560 | $300.00 | 1588765739 - NORTHWEST ENDOSCOPY CENTER, LLC | 911919202 - (WA) NORTHWEST ENDOSCOPY CENTER LLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27560 | $1301.00 | 1154844553 - LONE STAR ENDOSCOPY CENTER, LLC, LONE STAR ENDOSCOPY SOUTHLAKE | 273635726 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27560 | $606.00 | 1346468253 - FAIRVIEW MAPLE GROVE SURGERY CENTER, LLC | 208335586 - (MN) FAIRVIEW MAPLE GROVE SURGERY CENTER LLC | MN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27560 | $78.00 | 1952354326 - CENTER OF SURGICAL EXCELLENCE OF VENICE FLORIDA LLC | 202807874 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27560 | $375.00 | 1386999662 - PALOS HILLS SURGERY CENTER, LLC | 451617538 - (IL) PALOS HILLS SURGERY CENTER LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27560 | $60.00 | 1467844068 - WEST ANNAPOLIS SURGERY CENTER, LLC | 472474153 - (MD) WEST ANNAPOLIS SURGERY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27560 | $104.00 | 1528130879 - PACIFIC SURGICAL INSTITUTE OF PAIN MANAGEMENT | 330776873 - (CA) PACIFIC SURGICAL INSTITUTE OF PAIN MANAGEMENT | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27560 | $906.00 | 1073613162 - ROCKY MOUNTAIN SURGERY CENTER LLC | 870699657 - (CO) ROCKY MOUNTAIN SURGERY CENTER, LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27560 | $227.00 | 1922187103 - NORTH HILLS SURGERY CENTER, LLC, NORTH HILLS SURGERY CENTER | 710807771 - (AR) NORTH HILLS SURGERY CENTER LLC | AR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 27560 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 27560 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 27560 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 |
|---|---|---|
| 27560-CPT | Moderate | Clo Tx Patellar Disloc W/O Anes |
| 27562-CPT | Moderate | Tx Closed Patellar Dislocation;W Anesthe |
| 27566-CPT | High | Red Disloc Open-Patella |
| 27570-CPT | Moderate | Manipulation Of Knee Joint Under General Anesthesia (Includes Application Of Traction Or Other Fixation Devices) Rn Review Medicaid>=5/14/2011, Commercial>=7/5/2011 |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 27560. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 27560 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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