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See a sample rate comparisonCPT 27654 Fee Schedule
Last Verified: September 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.
Repair,2ndary,Ruptured Achilles Tendon,W
| 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 27654 |
| Medicaid Fee Schedule | View Medicaid rates for 27654 |
National average reimbursement for CPT 27654 by major payers:
$913.03
$966.93
$1,013.93
$1,182.32
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CPT 27654
5 of 25 sample ratesHigher to lower in this preview
Surgery Center Of Port Charlotte Ltd
$5,765.00Published rateBurlington County Endoscopy Center LLC
$4,074.00Published rateSurgcenter Of Bel Air
Surgcenter Of Bel Air, LLC
$2,814.00Published rateCarolina Mountain Gastroenterology Endoscopy Center
$1,679.00Published rateEye Surgery Center-Northland LLC
Eye Surgery Centernorthland LLC
$1,001.00Published rate
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See a sample payer proposalCPT 27654 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 27654 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 27654 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 |
|---|---|---|
| 27650-CPT | Moderate | Repair,Primary,Open/Percut.Ruptured Achi |
| 27652-CPT | Moderate | Repair Graft Achilles Tendon, Repair Primary Open Or Percutaneous Ruptured Achilles Tendon With Graft Includes Obtaining Graft |
| 27654-CPT | Moderate | Repair,2ndary,Ruptured Achilles Tendon,W |
| 27656-CPT | Moderate | Repair Leg Connective Tissue, Surgery To Repair A Problem (Abnormality) In The Strong Connective Tissue (Fascia) Of A Leg. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 27654. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 27654 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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