CPT 27635 Fee Schedule
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.
| 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 |
National average reimbursement for CPT 27635 by major payers:

$790.09

$795.61

$847.53

$990.13
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 27635 | ||||||
United | 27635 | $3623.00 | 1356704027 - GLEN ECHO SURGERY CENTER, LLC | 474049838 - (MD) GLEN ECHO SURGERY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27635 | $2565.00 | 1053481960 - AESTHETIC ASSOCIATES INC., P.S., SEATTLE FACIAL PLASTIC SURGERY CENTER | 911650765 - (WA) AESTHETIC ASSOCIATES INC PS | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27635 | $1427.00 | 1447225503 - BAPTIST DESOTO SURGERY CENTER, LP | 200804946 - (MS) BAPTIST DESOTO SURGERY CENTER LP | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27635 | $2116.00 | 1093389421 - PEACHTREE ORTHOPAEDIC SURGERY CENTER-NORTH, LLC | 862640910 - (GA) PEACHTREE ORTHOPAEDIC SURGERY CENTERNORTH LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27635 | $2025.00 | 1386721249 - ALLIED PHYSICIANS SURGERY CENTER, LLC | 352057452 - (IN) ALLIED PHYSICIANS SURGERY CENTER LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27635 | $1142.00 | 1811932270 - PHILADELPHIA SURGI CENTER, INC. | 232965126 | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27635 | $2406.00 | 1720001928 - CAMPBELL CLINIC SURGERY CENTER, LLC | 621826300 | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27635 | $1868.00 | 1144590332 - HEALTHCARE PARTNERS ASC-LB, LLC, DAVITA MEDICAL ASC | 954628842 - (CA) HEALTHCARE PARTNERS ASCLB LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27635 | $3124.00 | 1518634732 - MEDSTAR HEALTH ENDOSCOPY CENTER | 872341245 - (MD) MEDSTAR HEALTH ENDOSCOPY CENTER | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27635 | $1117.00 | 1598791105 - TOTAL EYE CARE SURGERY CENTER INC | 593519147 - (FL) TOTAL EYE CARE SURGERY CENTER INC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27635 | $1397.00 | 1598815110 - EXECUTIVE ENDOSCOPY, INC., ENDOSCOPY CENTER OF SAN JOSE | 770583401 - (CA) EXECUTIVE ENDOSCOPY INC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27635 | $1597.00 | 1235760406 - STAR SURGERY CENTER, LLC | 823216301 - (AZ) STAR SURGERY CENTER LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27635 | $3500.00 | 1750499950 - MEDPLEX OUTPATIENT SURGERY CENTER LTD, MEDPLEX OUTPATIENT SURGERY CENTER | 760353620 - (AL) MEDPLEX OUTPATIENT SURGERY CENTER LTD | AL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27635 | $3500.00 | 1548241623 - GASTROENTEROLOGY ASSOCIATES, LLC, GASTROENTEROLOGY ASSOCIATES ENDOSCOPY CENTER | 912104493 - (WA) GASTROENTEROLOGY ASSOCIATES PLLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27635 | $2700.00 | 1265931653 - HEALTHCARE ENTERPRISES LLC, THE SURGERY CENTER | 471428524 - (MA) HEALTHCARE ENTERPRISES LLC | MA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 27635 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 27635 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 27635 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.
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 27635. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 27635 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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