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CPT 27613 Fee Schedule

Last Verified: December 2025

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,Soft Tissues--Leg/Ankle; Superfic
Key FactDetail
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 LevelModerate

National average reimbursement for CPT 27613 by major payers:

bcbs

$320.15

uhc

$330.63

aetna

$331.05

cigna

$422.47

Preview provider-level rates for...
For billing codeCPT 27613
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 27613

United
27613$275.001720081664 - HEATON LASER AND SURGERY CENTER L L C752752100 - (TX) HEATON LASER AND SURGERY CENTER L L CTXAmbulatory Surgical Clinic/Center (261QA1903X)
United
27613$184.001487779435 - LAKEFOREST AMBULATORY SURGERY CENTER, DISTRICT HEIGHTS AMBULATORY SURGERY CENTER521944179 - (MD) LAKEFOREST AMBULATORY SURGERY CENTERMDAmbulatory Surgical Clinic/Center (261QA1903X)
United
27613$650.001174538748 - SPECIALTY SURGICAL CENTER, LLC, SPECIALTY SURGICAL CENTER954698130 - (CA) SPECIALTY SURGICAL CENTER, LLCCAAmbulatory Surgical Clinic/Center (261QA1903X)
United
27613$719.001740201607 - TALLAHASSEE ENDOSCOPY CENTER INC593050876 - (FL) TALLAHASSEE ENDOSCOPY CENTER INCFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
27613$585.001487612024 - QUAD CITY AMBULATORY SURGERY CENTER LLC364471903 - (IL) QUAD CITY AMBULATORY SURGERY CENTER LLCILAmbulatory Surgical Clinic/Center (261QA1903X)
United
27613$350.001730382789 - ENDOSCOPY CENTER260317060 - (NC) ENDOSCOPY CENTERNCAmbulatory Surgical Clinic/Center (261QA1903X)
United
27613$433.001659657856 - ALFA SURGERY CENTER, LLC452748642 - (CA) ALFA SURGERY CENTER, LLCCAAmbulatory Surgical Clinic/Center (261QA1903X)
United
27613$354.001811947062 - WACO GASTROENTEROLOGY ENDOSCOPY CENTER LLC, WACO GASTROENTEROLOGY ENDOSCOPY CENTER43636953 - (TX) WACO GASTROENTEROLOGY ENDOSCOPY CENTER LLCTXAmbulatory Surgical Clinic/Center (261QA1903X)
United
27613$610.001245297662 - WOODLAND SURGERY CENTER LLC391998961 - (WI) WOODLAND SURGERY CENTER, LLCWIAmbulatory Surgical Clinic/Center (261QA1903X)
United
27613$487.001194790808 - DIGESTIVE ENDOSCOPY CENTER LLC311508446 - (OH) DIGESTIVE ENDOSCOPY CENTER, LLCOHAmbulatory Surgical Clinic/Center (261QA1903X)
United
27613$1787.001538164546 - SURGERY CENTER AT PELHAM, LLC760745215 - (SC) SURGERY CENTER AT PELHAM, LLCSCAmbulatory Surgical Clinic/Center (261QA1903X)
United
27613$1139.001528121316 - SAINT LUKES SOUTH SURGERY CENTER LLC201721929 - (KS) SAINT LUKES SOUTH SURGERY CENTER LLCKSAmbulatory Surgical Clinic/Center (261QA1903X)
United
27613$450.001881687614 - TURKS HEAD SURGERY CENTER LLC200184603 - (PA) TURK'S HEAD SURGERY CENTER, L.L.C.PAAmbulatory Surgical Clinic/Center (261QA1903X)
United
27613$1553.001083912745 - RED ROCKS SURGERY CENTERS, LLC271095323 - (CO) RED ROCKS SURGERY CENTERS LLCCOAmbulatory Surgical Clinic/Center (261QA1903X)
United
27613$304.001720509722 - CLEVELAND EAST VASCULAR CARE, LLC461853653 - (OH) CLEVELAND EAST VASCULAR CARE LLCOHAmbulatory 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 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.

CodeComplexityDescription
27612-CPTModerateArthrotomy Ankle W Post Release
27613-CPTModerateBiopsy,Soft Tissues--Leg/Ankle; Superfic
27614-CPTModerateBiopsy Soft Tissue Leg Deep
27615-CPTHighRadical Resection Of Tumor (Eg Sarcoma) Soft Tissue Of Leg Or Ankle Area; Less Than 5 Cm (Revised 01/01/2014)

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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