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See a sample rate comparisonCPT 27613 Fee Schedule
Last Verified: September 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.
Biopsy Of Tissue Under Skin, A Procedure To Remove A Sample Of Soft Tissue From Near The Skin Surface For Testing (Biopsy).
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | None 11 - Office 99 - Other POS |
| Common Modifiers | None 51 - Multiple procedures LT - Left side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 27613 |
| Medicaid Fee Schedule | View Medicaid rates for 27613 |
National average reimbursement for CPT 27613 by major payers:
$320.15
$330.63
$331.05
$407.87
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CPT 27613
5 of 25 sample ratesHigher to lower in this preview
The Emory Clinic Inc, Emory Orthopaedic Surgery Center
Emory Ambulatory Surgery Center At Dunwoody LLC
$1,817.00Published rateOro Valley Surgical Suites LLC
Oro Valley Surgical Suites, LLC
$1,158.00Published rateCommonwealth Eye Clinic Inc
$541.00Published rateDeerbrook Asc LLC
$413.00Published rateCynthia Kiesel
Deaconess Hospital Inc
$202.94Published rate
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See a sample payer proposalCPT 27613 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 27613 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 27613 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 |
|---|---|---|
| 27612-CPT | Moderate | Arthrotomy Posteri Capsulr Rlease Ankle W//W/O Achille, Arthrotomy Posterior Capsular Release Ankle With Or Without Achille |
| 27613-CPT | Moderate | Biopsy Of Tissue Under Skin, A Procedure To Remove A Sample Of Soft Tissue From Near The Skin Surface For Testing (Biopsy). |
| 27614-CPT | Moderate | Biops Sft Tissue Of Leg/Ankle Area; Deep (Subfasci Or Intramus, Biopsy Soft Tissue Of Leg Or Ankle Area; Deep (Subfascial Or Intramus |
| 27615-CPT | High | Radical Resection Of Tumor (Eg, Radical Resection Of Tumor (Eg Malignant Neoplasm) Soft Tissue Of Leg Or Ankle Area Less Than 5 Cm |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 27613. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 27613 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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