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See a sample rate comparisonCPT 27630 Fee Schedule
Last Verified: October 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.
Xcision Of Lesion Of Tndon Sheath Or Cpsul(Eg Cyst Or Ganglion, Excision Of Lesion Of Tendon Sheath Or Capsule (Eg Cyst Or Ganglion)
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 24 - Ambulatory Surgical Center 22 - On Campus Outpatient Hospital |
| Common Modifiers | None RT - Right side of body LT - Left side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 27630 |
| Medicaid Fee Schedule | View Medicaid rates for 27630 |
National average reimbursement for CPT 27630 by major payers:
$664.64
$727.65
$752.87
$610.98
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CPT 27630
5 of 25 sample ratesHigher to lower in this preview
Surgicenter Of Kansas City, LLC
$3,273.00Published rateSurgcenter Camelback LLC
$2,206.00Published rateSurgery Center Of Athens LLC
$1,453.00Published rateAmerican Eye Surgery Center, Inc.
American Eye Surgery Center Inc
$900.00Published rateBarbara Zimmer
Deaconess Hospital Inc
$449.36Published rate
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See a sample payer proposalCPT 27630 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 27630 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 27630 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 |
|---|---|---|
| 27610-CPT | Moderate | Arthrotomy Ankle Including E, Arthrotomy Ankle Including Exploration Drainage Orremoval Of Foreign Body Arthrotomy Ankle Including Exploration Drainage Or |
| 27612-CPT | Moderate | Arthrotomy Posteri Capsulr Rlease Ankle W//W/O Achille, Arthrotomy Posterior Capsular Release Ankle With Or Without Achille |
| 27620-CPT | Moderate | 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. |
| 27630-CPT | Moderate | Xcision Of Lesion Of Tndon Sheath Or Cpsul(Eg Cyst Or Ganglion, Excision Of Lesion Of Tendon Sheath Or Capsule (Eg Cyst Or Ganglion) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 27630. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 27630 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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