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See a sample rate comparisonHealthcare providers use this code to document and receive reimbursement for visits that address high-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 | 22 - On Campus Outpatient Hospital 24 - Ambulatory Surgical Center |
| Common Modifiers | None LT - Left side of body RT - Right side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 27615 |
| Medicaid Fee Schedule | View Medicaid rates for 27615 |
National average reimbursement for CPT 27615 by major payers:

$1,320.68

$1,353.78

$1,393.58

$1,641.51
Choose a payer to see a sample of rates for CPT 27615.
Synergy Surgicenter LLC
Memorial Surgery Center LLC
North Florida Surgery Center Inc
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Rate Benchmarking
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See a sample rate comparisonPayer Contract Negotiation
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 27615 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 27615 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 27615 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 |
|---|---|---|
| 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 |
| 27616-CPT | High | Radical Resection Of Tumor (Eg, Radical Resection Of Tumor (Eg Malignant Neoplasm) Soft Tissue Of Leg Or Ankle Area 5 Cm Or Greater |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 27615. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 27615 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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