CPT 27656 Fee Schedule
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.
| 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 | Moderate |
National average reimbursement for CPT 27656 by major payers:

$675.88

$805.40

$776.67

$920.99
| 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 27656 | ||||||
United | 27656 | $390.00 | 1023134640 - LOCUST GROVE ENDO CENTER | 205860757 - (GA) LOCUST GROVE ENDO CENTER | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27656 | $1150.00 | 1275513806 - PINNACLE CATARACT AND LASER INSTITUTE LLC | 743117000 - (WI) PINNACLE CATARACT AND LASER INSTITUTE LLC | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27656 | $1130.00 | 1104822808 - AGMG ENDOSCOPY CENTER A GENERAL PARTNERSHIP | 330885760 - (CA) AGMG ENDOSCOPY CENTER A GENERAL PARTNERSHIP | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27656 | $2408.00 | 1093960700 - PROLIANCE SURGEONS, INC., P.S., PROLIANCE HIGHLANDS SURGERY CENTER | 911606533 - (WA) PROLIANCE SURGEONS, INC., P.S. | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27656 | $1450.00 | 1932782315 - WAKE SPINE AND SPECIALTY SURGERY CENTER LLC, RALEIGH NEUROSURGICAL AND SPINE SURGERY CENTER | 842694789 - (NC) WAKE SPINE & SPECIALTY SURGERY | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27656 | $622.00 | 1588644520 - WESTGLEN ENDOSCOPY CENTER LLC, WESTGLEN ENDOSCOPY CENTER | 621707329 - WESTGLEN ENDOSCOPY CENTER LLC | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27656 | $2307.00 | 1063099190 - ASCENSION SAINT THOMAS LEBANON SURGERY CENTER LLC, LEBANON SURGERY CENTER | 862679471 | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27656 | $1035.00 | 1770572307 - BETHESDA SURGERY CENTER, LLC | 522080005 - (MD) BETHESDA SURGERY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27656 | $818.00 | 1497347934 - INTEGRIS DDSI ENDOSCOPY CENTERS LLC | 854253589 | OK | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27656 | $1673.00 | 1972911030 - SOUTHEASTERN AMBULATORY SURGERY CENTER, LLC, THE SURGERY CENTER AT SOUTHEASTERN HEALTH PARK | 452413077 - (NC) SOUTHEASTERN AMBULATORY SURGERY CENTER, LLC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27656 | $558.00 | 1285673186 - BERKSHIRE COSMETIC & RECONSTRUCTIVE SURGERY CENTER INC. | 43421240 - (MA) BERKSHIRE COSMETIC RECONSTRUCTIVE SURGERY CENTER INC | MA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27656 | $2353.00 | 1720530405 - GRAND RAPIDS SURGICAL SUITES LLC | 811321919 - (MI) GRAND RAPIDS SURGICAL SUITES, PLLC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27656 | $1232.00 | 1104858513 - DOCTORS OUTPATIENT SURGERY CENTER LLC, SURGERY CENTER | 721341061 - (LA) DOCTORS OUTPATIENT SURGERY CENTER LLC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27656 | $525.00 | 1447442876 - MAPLE SPRINGS PODIATRIC SURGICAL CENTER, INC | 521883407 - (MD) MAPLE SPRINGS PODIATRIC SURGICAL CENTER INC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27656 | $2859.00 | 1356621239 - MIDLAND TEXAS SURGICAL CENTER, LLC, TEXAS SURGICAL CENTER, AN AFFILIATE OF MIDLAND MEMORIAL HOSPITAL | 453047741 | TX | 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 27656 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 27656 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 27656 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.
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 27656. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 27656 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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