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See a sample rate comparisonCPT 27616 Fee Schedule
Medicare rates as of October 2026
CPT 27616 is classified under Surgery, in the Surgical Procedures on the Musculoskeletal System subgroup.
Radical Resection Of Tumor (Eg, Radical Resection Of Tumor (Eg Malignant Neoplasm) Soft Tissue Of Leg Or Ankle Area 5 Cm Or Greater
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 22On Campus Outpatient Hospital 21Inpatient Hospital |
| Common Modifiers | LTLeft side of body RTRight side of body |
| Hospital Outpatient Group (APC) | APC 5073 - Level 3 Excision/ Biopsy/ Incision and Drainage |
| Surgery Center Payment (ASC) | G2 - Paid separately, from the OPPS relative weight |
| Common Revenue Codes | 0360 |
| Medicare Fee Schedule | $1,158.68 national non-facility rate (2026)View Medicare rates for 27616 |
| Medicaid Fee Schedule | $908.36 median of the 8 states in the free previewView Medicaid rates for 27616 |
National average reimbursement for CPT 27616 by major payers:
$1,762.63
BCBS / Anthem
$1,749.45
UnitedHealthcare
$1,783.86
Aetna
$2,086.46
Cigna
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 27616.
CPT 27616
5 of 25 sample ratesHigher to lower in this preview
Santa Barbara Surgery Center Lp
$2,859.00Published rateJoliet Surgery Center Limited Partnership, Amsurg Surgery Center
Joliet Surgery Center Limited Partnership
$2,150.00Published rateSurgcenter Northern Phoenix LLC
$1,713.00Published rateTriad Surgery Center LLC, Triad Eye Medical Clinic And Cataract Institute PLLC
$1,026.00Published rate481 Asc Project LLC, Eye Md Laser & Surgery Center LLC
481 Asc Project LLC
$723.00Published rate
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See a sample payer proposalCPT 27616 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The table lists codes related to 27616. Select one to see its fee schedule.
| Code | Description |
|---|---|
| 27613-CPT | Biopsy Of Tissue Under Skin, A Procedure To Remove A Sample Of Soft Tissue From Near The Skin Surface For Testing (Biopsy). |
| 27614-CPT | 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 | 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 | 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 27616. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 27616 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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Frequently Asked Questions
What APC is CPT 27616 assigned to?
Medicare's hospital outpatient payment system (OPPS) assigns CPT 27616 to APC 5073 (Level 3 Excision/ Biopsy/ Incision and Drainage). An APC groups outpatient services that Medicare pays at the same base rate.
How does Medicare pay for CPT 27616 in an ambulatory surgery center?
CMS lists CPT 27616 with ASC payment indicator G2: Paid separately, from the OPPS relative weight.
Which revenue codes are billed with CPT 27616?
Hospital price transparency files list CPT 27616 under these revenue codes: 0360. A revenue code names the hospital department or charge category for the line; it does not change what the service is.