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See a sample rate comparisonCPT 27604 Fee Schedule
Last Verified: October 2026
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.
Drain Leg Or Ankle Infection, Surgery To Cut Open And Drain A Deep Infection Or Collection Of Blood (Hematoma) Of The Leg Or Ankle.
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 21 - Inpatient Hospital 24 - Ambulatory Surgical Center 22 - On Campus Outpatient Hospital |
| Common Modifiers | None RT - Right side of body LT - Left side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 27604 |
| Medicaid Fee Schedule | View Medicaid rates for 27604 |
National average reimbursement for CPT 27604 by major payers:
$578.63
$627.32
$626.44
$566.38
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CPT 27604
5 of 25 sample ratesHigher to lower in this preview
Wisconsin Institute Of Surgical Excellence LLC
$3,767.00Published rateCapital Orthopaedic Surgery Center, LLC, Capital Orthopaedic Surgery Center
Capital Orthopaedic Surgery Center LLC
$1,904.00Published rateSpeedway Surgical Specialists, LLC
Speedway Surgical Specialists LLC
$1,500.00Published rateBrown Urology, Inc., Collyer Street Operatory
Brown Urology Inc
$1,052.00Published rateDewey Driscoll
Deaconess Hospital Inc
$384.25Published rate
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See a sample payer proposalCPT 27604 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 27604 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 27604 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 |
|---|---|---|
| 27603-CPT | Moderate | Drain Leg Or Ankle Infection, Surgery To Cut Open And Drain A Deep Infection Or Collection Of Blood (Hematoma) Of The Leg Or Ankle. |
| 27604-CPT | Moderate | Drain Leg Or Ankle Infection, Surgery To Cut Open And Drain A Deep Infection Or Collection Of Blood (Hematoma) Of The Leg Or Ankle. |
| 27605-CPT | Moderate | Tenotomy Percutane Achilles Tndon (Sepa Proc); Local An, Tenotomy Percutaneous Achilles Tendon (Separate Procedure); Local An |
| 27606-CPT | Moderate | Tenotomy Percutane Achilles Tndon (Sepa Proc); Gnral, Tenotomy Percutaneous Achilles Tendon (Separate Procedure); General |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 27604. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 27604 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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