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See a sample rate comparisonCPT 27654 Fee Schedule
Medicare rates as of October 2026
CPT 27654 is classified under Surgery, in the Surgical Procedures on the Musculoskeletal System subgroup.
Repair,2ndary,Ruptured Achilles Tendon,W
| 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 5114 - Level 4 Musculoskeletal Procedures |
| Surgery Center Payment (ASC) | J8 - Device-intensive procedure, paid at an adjusted rate |
| Common Revenue Codes | 03600975Sign up to view all 6 |
| Medicare Fee Schedule | $676.03 national non-facility rate (2026)View Medicare rates for 27654 |
| Medicaid Fee Schedule | $545.265 median of the 8 states in the free previewView Medicaid rates for 27654 |
National average reimbursement for CPT 27654 by major payers:
$913.03
BCBS / Anthem
$966.93
UnitedHealthcare
$1,013.93
Aetna
$1,182.32
Cigna
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 27654.
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 table lists codes related to 27654. Select one to see its fee schedule.
| Code | Description |
|---|---|
| 27650-CPT | Repair,Primary,Open/Percut.Ruptured Achi |
| 27652-CPT | Repair Graft Achilles Tendon, Repair Primary Open Or Percutaneous Ruptured Achilles Tendon With Graft Includes Obtaining Graft |
| 27654-CPT | Repair,2ndary,Ruptured Achilles Tendon,W |
| 27656-CPT | 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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Frequently Asked Questions
What APC is CPT 27654 assigned to?
Medicare's hospital outpatient payment system (OPPS) assigns CPT 27654 to APC 5114 (Level 4 Musculoskeletal Procedures). An APC groups outpatient services that Medicare pays at the same base rate.
How does Medicare pay for CPT 27654 in an ambulatory surgery center?
CMS lists CPT 27654 with ASC payment indicator J8: Device-intensive procedure, paid at an adjusted rate.
Which revenue codes are billed with CPT 27654?
Hospital price transparency files list CPT 27654 under these revenue codes: including 0360, 0975, 0960, 0490 and 0989. A revenue code names the hospital department or charge category for the line; it does not change what the service is.