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See a sample rate comparisonCPT 27656 Fee Schedule
Medicare rates as of October 2026
CPT 27656 is classified under Surgery, in the Surgical Procedures on the Musculoskeletal System subgroup.
Repair Leg Connective Tissue, Surgery To Repair A Problem (Abnormality) In The Strong Connective Tissue (Fascia) Of A Leg.
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 22On Campus Outpatient Hospital 24Ambulatory Surgical Center |
| Common Modifiers | RTRight side of body LTLeft side of body |
| Hospital Outpatient Group (APC) | APC 5113 - Level 3 Musculoskeletal Procedures |
| Surgery Center Payment (ASC) | A2 - Paid separately, from the OPPS relative weight |
| Common Revenue Codes | 0360 |
| Medicare Fee Schedule | $531.74 national non-facility rate (2026)View Medicare rates for 27656 |
| Medicaid Fee Schedule | $426.50 median of the 8 states in the free previewView Medicaid rates for 27656 |
National average reimbursement for CPT 27656 by major payers:
$675.88
BCBS / Anthem
$805.40
UnitedHealthcare
$776.67
Aetna
$611.02
Cigna
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 27656.
CPT 27656
5 of 25 sample ratesHigher to lower in this preview
Aurora Surgery Centers, LLC
Aurora Surgery Centers LLC
$7,810.00Published rateWest Chester Surgical Suites, LLC
West Chester Surgical Suites LLC
$2,307.00Published rateCoal Creek Ambulatory Surgery Center PC, Coal Creek Ambulatory Surgery Center
Coal Creek Ambulatory Surgery Center PC
$1,225.00Published rateIntegris Ddsi Endoscopy Centers LLC
$818.00Published rateBetter Living Endoscopy Center
$525.00Published rate
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See a sample payer proposalCPT 27656 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The table lists codes related to 27656. 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 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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Frequently Asked Questions
What APC is CPT 27656 assigned to?
Medicare's hospital outpatient payment system (OPPS) assigns CPT 27656 to APC 5113 (Level 3 Musculoskeletal Procedures). An APC groups outpatient services that Medicare pays at the same base rate.
How does Medicare pay for CPT 27656 in an ambulatory surgery center?
CMS lists CPT 27656 with ASC payment indicator A2: Paid separately, from the OPPS relative weight.
Which revenue codes are billed with CPT 27656?
Hospital price transparency files list CPT 27656 under these revenue codes: 0360. A revenue code names the hospital department or charge category for the line; it does not change what the service is.