CPT 27640 Fee Schedule
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.
| 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 | High |
| Medicare Fee Schedule | View Medicare rates for 27640 |
National average reimbursement for CPT 27640 by major payers:

$1,126.83

$1,146.82

$1,190.70

$1,414.75
| 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 27640 | ||||||
United | 27640 | $1035.00 | 1396828323 - EYE CARE SURGERY CENTER OF MEMPHIS, LLC | 470920340 | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27640 | $1031.00 | 1568460889 - EYE ASSOCIATES OF MANATEE LLP, EYE ASSOCIATES SURGERY CENTER | 650105559 - (FL) THE EYE ASSOCIATES | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27640 | $3623.00 | 1043605934 - SEASIDE SURGERY CENTER, LLC | 472399984 - (FL) SEASIDE SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27640 | $1050.00 | 1144482753 - CLARKSVILLE EYE SURGERY CENTER | 261815638 - (TN) CLARKSVILLE EYE SURGERY CENTER | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27640 | $992.00 | 1255746087 - OSI, LLC | 352509822 - (MI) OSI, LLC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27640 | $1900.00 | 1598276404 - BALBOA NEPHROLOGY MEDICAL GROUP,INC., SAN DIEGO ACCESS AND SURGERY CENTER | 952848091 - (CA) BALBOA NEPHROLOGY MEDICAL GROUP, INC. | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27640 | $3570.00 | 1790344182 - BRISTOL AMBULATORY SURGERY CENTER, LLC | 834345983 | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27640 | $5124.00 | 1952364499 - DENTON REGIONAL AMBULATORY SURGERY CENTER, L.P., MEDICAL CITY SURGERY CENTER/DENTON | 200270605 - (TX) DENTON REGIONAL AMBULATORY SURGERY CENTER LP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27640 | $3052.00 | 1356572465 - ORCHARD CREEK SURGERY CENTER, ORCHARD CREEK SURGERY CENTER | 770498874 - (CA) ORCHARD CREEK SURGERY CENTER | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27640 | $1335.00 | 1801073648 - ELITE ENDOSCOPY LLC | 202722461 - (NV) ELITE ENDOSCOPY LLC | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27640 | $2084.00 | 1689852618 - MILLARD FILLMORE SURGERY CENTER, LLC | 261582864 - (NY) MILLARD FILLMORE SURGERY CENTER, LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27640 | $3952.00 | 1649287269 - BAPTIST PLAZA SURGICARE LP, SAINT THOMAS SURGERY CENTER - MIDTOWN | 800033564 | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27640 | $6904.00 | 1558331801 - MEMORIAL HERMANN SURGERY CENTER, MEMORIAL HERMANN SURGERY CENTER, THE WOODLANDS | 201765863 - (TX) MEMORIAL HERMANN SURGERY CENTER | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27640 | $1455.94 | 1497741474 - CARLOS GIAMMATTEI | 350593390 - DEACONESS HOSPITAL INC | IN | Anesthesiology Physician (207L00000X) |
United | 27640 | $2451.00 | 1578876124 - GOLD COAST SURGICENTER, LLC | 271495683 - (IL) GOLD COAST SURGICENTER, LLC | IL | 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 27640 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 27640 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 27640 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 | Excision Tumor Soft Tissue Leg Ankle Subq 5 Cm |
| 27634-CPT | Moderate | Exc Tumor Soft Tissue Leg Ankle Subfasc 5 Cm |
| 27635-CPT | Moderate | Exc Bone Lesion Leg |
| 27640-CPT | High | Partial Excision (Craterization Saucerization Or Diaphysectomy) 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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