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See a sample rate comparisonCPT 27640 Fee Schedule
CPT 27640 is classified under Surgery, in the Surgical Procedures on the Musculoskeletal System subgroup.
Partial Excision (Craterizatio, Partial Excision (Craterization Saucerization Ordiaphysectomy) Bone (Eg Osteomyelitis Or Exostosis) Tibia
| 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 |
| Add-on Codes | 2070020702 |
| Common Revenue Codes | 03600960Sign up to view all 4 |
| Medicare Fee Schedule | View Medicare rates for 27640 |
| Medicaid Fee Schedule | $615.415 median of the 8 states in the free previewView Medicaid rates for 27640 |
National average reimbursement for CPT 27640 by major payers:
$1,126.83
BCBS / Anthem
$1,146.82
UnitedHealthcare
$1,190.70
Aetna
$1,382.39
Cigna
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 27640.
CPT 27640
5 of 25 sample ratesHigher to lower in this preview
Memorial Hermann Surgery Center, Memorial Hermann Surgery Center, The Woodlands
Memorial Hermann Surgery Center
$6,904.00Published rateWindsor Mill Surgery Center, LLC
Windsor Mill Surgery Center LLC
$3,188.00Published rateBalboa Nephrology Medical Group,Inc., San Diego Access And Surgery Center
Balboa Nephrology Medical Group, Inc.
$1,900.00Published ratePatrick Duffy
Deaconess Hospital Inc
$1,455.94Published rateOsi, LLC
$992.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 27640 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The table lists codes related to 27640. Select one to see its fee schedule.
| Code | Description |
|---|---|
| 27632-CPT | 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 | 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 | 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). |
| 27640-CPT | Partial Excision (Craterizatio, Partial Excision (Craterization Saucerization Ordiaphysectomy) Bone (Eg Osteomyelitis Or Exostosis) Tibia |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 27640. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 27640 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 27640 assigned to?
Medicare's hospital outpatient payment system (OPPS) assigns CPT 27640 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 27640 in an ambulatory surgery center?
CMS lists CPT 27640 with ASC payment indicator A2: Paid separately, from the OPPS relative weight.
Which add-on codes are billed with CPT 27640?
CMS add-on code edits list CPT 27640 as a primary code for these add-on codes: 20700 and 20702.
Which revenue codes are billed with CPT 27640?
Hospital price transparency files list CPT 27640 under these revenue codes: 0360, 0960, 0361 and 0761. A revenue code names the hospital department or charge category for the line; it does not change what the service is.