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See a sample rate comparisonCPT 27625 Fee Schedule
Medicare rates as of October 2026
CPT 27625 is classified under Surgery, in the Surgical Procedures on the Musculoskeletal System subgroup.
Remove Lining Of Ankle Joint, Exploration Of Ankle Joint. The Procedure Includes Removal Of Inflamed Joint Lining To Alleviate Pain.
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 24Ambulatory Surgical Center 22On Campus Outpatient Hospital |
| Common Modifiers | RTRight side of body LTLeft side of body |
| Hospital Outpatient Group (APC) | APC 5113 - Level 3 Musculoskeletal Procedures |
| Surgery Center Payment (ASC) | A2 - Paid separately, from the OPPS relative weight |
| Common Revenue Codes | 03600960 |
| Medicare Fee Schedule | $548.11 national non-facility rate (2026)View Medicare rates for 27625 |
| Medicaid Fee Schedule | $441.56 median of the 8 states in the free previewView Medicaid rates for 27625 |
National average reimbursement for CPT 27625 by major payers:
$801.35
BCBS / Anthem
$790.62
UnitedHealthcare
$813.41
Aetna
$957.51
Cigna
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 27625.
CPT 27625
5 of 25 sample ratesHigher to lower in this preview
Fairview Maple Grove Surgery Center, LLC
Fairview Maple Grove Surgery Center LLC
$4,152.00Published rateProvidence Health Services Of Waco, Providence Health Center
Ascension Providence
$3,038.00Published rateSalina Surgical Arts Center, LLC, David A. Hendrick M.D., P.A.
David A. Hendrick Md
$2,204.00Published rateCarnegie Hill Endoscopy LLC
$1,358.00Published rateOcean County Eye Associates LLC, Ocean County Eye Surgery Center
Ocean County Eye Associates, P.C.
$730.00Published rate
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See a sample payer proposalCPT 27625 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The table lists codes related to 27625. Select one to see its fee schedule.
| Code | Description |
|---|---|
| 27610-CPT | Arthrotomy Ankle Including E, Arthrotomy Ankle Including Exploration Drainage Orremoval Of Foreign Body Arthrotomy Ankle Including Exploration Drainage Or |
| 27612-CPT | Arthrotomy Posteri Capsulr Rlease Ankle W//W/O Achille, Arthrotomy Posterior Capsular Release Ankle With Or Without Achille |
| 27620-CPT | Exploratory Surgery Of Ankle, Surgery To Explore An Ankle Joint. The Procedure May Involve Removal Of Tissue For Testing (Biopsy) Or Removal Of A Foreign Object. |
| 27625-CPT | Remove Lining Of Ankle Joint, Exploration Of Ankle Joint. The Procedure Includes Removal Of Inflamed Joint Lining To Alleviate Pain. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 27625. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 27625 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 27625 assigned to?
Medicare's hospital outpatient payment system (OPPS) assigns CPT 27625 to APC 5113 (Level 3 Musculoskeletal Procedures). An APC groups outpatient services that Medicare pays at the same base rate.
How does Medicare pay for CPT 27625 in an ambulatory surgery center?
CMS lists CPT 27625 with ASC payment indicator A2: Paid separately, from the OPPS relative weight.
Which revenue codes are billed with CPT 27625?
Hospital price transparency files list CPT 27625 under these revenue codes: 0360 and 0960. A revenue code names the hospital department or charge category for the line; it does not change what the service is.