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 |
| Medicare Fee Schedule | View Medicare rates for 27656 |
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 | $1439.00 | 1710336763 - MT PLEASANT SURGERY CENTER LLC | 300872082 - (MI) MT PLEASANT SURGERY CENTER LLC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27656 | $525.00 | 1295824100 - BETTER LIVING ENDOSCOPY CENTER | 640877920 - (MS) BETTER LIVING ENDOSCOPY CENTER | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27656 | $1225.00 | 1417294745 - COAL CREEK AMBULATORY SURGERY CENTER PC, COAL CREEK AMBULATORY SURGERY CENTER | 474079291 - (CO) COAL CREEK AMBULATORY SURGERY CENTER PC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27656 | $1000.00 | 1174615702 - I CARE CENTER LLC, CENTRAL INDIANA SURGERY CENTER | 351937200 - (IN) ICARE CENTER DBA CENTRAL INDIANA SURGERY CENTER, LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27656 | $1248.00 | 1447258603 - SNOWDEN RIVER SURGERY CENTER LLC | 200946902 - (MD) SNOWDEN RIVER SURGERY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27656 | $664.00 | 1487651956 - TRI-STATE GASTROENTEROLOGY ASSOCIATES, PSC, TRI-STATE DIGESTIVE DISORDER CENTER | 611192347 - (KY) TRI-STATE GASTROENTEROLOGY ASSOCIATES, PSC | KY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27656 | $1108.45 | 1164003224 - RACHEL SILLIMAN | 350593390 - DEACONESS HOSPITAL INC | MI | Hospitalist Physician (208M00000X) |
United | 27656 | $818.00 | 1497347934 - INTEGRIS DDSI ENDOSCOPY CENTERS LLC | 854253589 | OK | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27656 | $1048.00 | 1205917101 - CATARACT & LASER CENTER, INC. | 42907424 - (MA) THE CATARACT AND LASER CENTER, I | MA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27656 | $2529.00 | 1477900710 - BJOSC, LLC, BJOSC AT PLOVER | 300391378 - BJOSC LLC | WI | 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 | $2388.00 | 1245529189 - CAPITOL SURGICAL CENTER LLC | 275067646 | MD | 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 | $2243.00 | 1346207875 - GREENSBORO SPECIALTY SURGERY CENTER LIMITED PARTNERSHIP | 364053840 - (NC) GREENSBORO SPECIALTY SURGERY CENTER LIMITED PARTNERSHIP | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27656 | $613.00 | 1821336371 - EYECARE SURGERY CENTER, LLC | 461073660 - (MS) EYECARE SURGERY CENTER LLC | MS | 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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