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See a sample rate comparisonCPT 27638 Fee Schedule
Last Verified: October 2026
Healthcare 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.
Remove Noncancerous Growth, Surgery To Remove A Pocket Of Fluid (Cyst) Or A Noncancerous Growth (Tumor) From A Bone In The Lower Leg (Tibia Or Fibula). The Area Is Repaired With A Bone Graft.
| 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 RT - Right side of body LT - Left side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 27638 |
| Medicaid Fee Schedule | View Medicaid rates for 27638 |
National average reimbursement for CPT 27638 by major payers:
$1,031.85
$1,043.36
$1,081.95
$1,249.77
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CPT 27638
5 of 25 sample ratesHigher to lower in this preview
Women'S Specialty Surgery Center Of Dallas, LLC
Texas Health Women'S Specialty Surgery Center Of Dallas, LLC
$6,342.00Published rateUrology Asc- Phoenix, LLC, Urologic Surgery Center Of Arizona
$3,500.00Published rateOpen Access Vascular Access Center, Inc
Open Access Vascular Access Ce
$2,153.00Published rateSurgical Services Of Michigan, LLC, Blake Woods Medical Park
Blake Woods Medical Park
$1,500.00Published rateNortheast Ambulatory Center Inc
Northeast Ambulatory Center, Inc.
$519.00Published rate
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See a sample payer proposalCPT 27638 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 27638 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 27638 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 |
|---|---|---|
| 27632-CPT | Moderate | Xcision Tumor Sft Tissue Of Leg/Ankle Area Subcutane 3 Cm, Excision Tumor Soft Tissue Of Leg Or Ankle Area Subcutaneous; 3 Cm |
| 27634-CPT | Moderate | Exc Leg Ankle Tum Dep 5 Cm, Excision Tumor Soft Tissue Of Leg Or Ankle Area Subfascial Eg Intramuscular 5 Cm Or Greater |
| 27635-CPT | Moderate | Remove Noncancerous Growth, Surgery To Remove A Pocket Of Fluid (Cyst) Or A Noncancerous Growth (Tumor) From A Bone In The Lower Leg (Tibia Or Fibula). |
| 27638-CPT | High | Remove Noncancerous Growth, Surgery To Remove A Pocket Of Fluid (Cyst) Or A Noncancerous Growth (Tumor) From A Bone In The Lower Leg (Tibia Or Fibula). The Area Is Repaired With A Bone Graft. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 27638. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 27638 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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