CPT 27695 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 | 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 27695 |
| Medicaid Fee Schedule | View Medicaid rates for 27695 |
National average reimbursement for CPT 27695 by major payers:

$669.07

$654.88

$683.63

$805.19
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
United | 27695 | $7825.00 | 1891935201 - EAST CAMPUS SURGERY CENTER LLC | 352028517 - (IN) EAST CAMPUS SURGERY CENTER LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27695 | $2299.00 | 1235567264 - WENTWORTH SURGERY CENTER, LLC | 900975592 - (NH) WENTWORTH SURGERY CENTER LLC | NH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27695 | $6904.00 | 1124492541 - MEMORIAL HERMANN SURGERY CENTER PINECROFT, LLC | 371796296 - (TX) MEMORIAL HERMANN SURGERY CENTER PINECROFT LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27695 | $3500.00 | 1396120168 - STAMFORD ASC LLC | 465569848 - (CT) STAMFORD ASC LLC | CT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27695 | $5466.00 | 1174587984 - ST MARKS AMBULATORY SURGERY ASSOCIATES LP, MT. OLYMPUS SURGERY CENTER | 621449273 - (UT) ST MARKS AMBULATORY SURGERY ASSOCIATES LP | UT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27695 | $1208.00 | 1588876817 - FREEWAY SURGERY CENTER LLC | 208957938 - (AR) FREEWAY SURGERY CENTER LLC | AR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27695 | $837.73 | 1548258684 - GIHAN KADER | 350593390 - DEACONESS HOSPITAL INC | MO | Neurology Physician (2084N0400X) |
United | 27695 | $1680.00 | 1902852841 - MIDTOWN UROLOGY SURGICAL CENTER, PC | 582022094 | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27695 | $1608.00 | 1306503057 - PAIN CARE SURGERY OF LOUISVILLE, LLC | 844317137 - (KY) PAIN CARE SURGERY OF LOUISVILLE LLC | KY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27695 | $1016.00 | 1215957816 - SURGERY CENTER OF CENTRAL VIRGINIA INC., D.B.A. EYE SURGERY CENTER | 541816412 - (VA) SURGERY CENTER OF CENTRAL VIRGINIA INC | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27695 | $4293.00 | 1447213954 - REAGAN STREET SURGERY CENTER, LLC | 201484668 - (CA) REAGAN STREET SURGERY CENTER LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27695 | $9270.00 | 1053770149 - AURORA SURGERY CENTERS, LLC | 811401714 - (WI) AURORA SURGERY CENTERS LLC | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27695 | $1387.00 | 1982105458 - HEART CARE CENTER, LLC | 824195385 | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27695 | $2200.00 | 1194959809 - BEVERLY HILLS REGIONAL SURGERY CENTER LP | 263718069 - (CA) BEVERLY HILLS REGIONAL SURGERY CENTER LP | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27695 | $2204.00 | 1780199356 - GEORGIA UROLOGY ASC CUMMING | 550846177 | GA | 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 27695 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 27695 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 27695 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 |
|---|---|---|
| 27695-CPT | Moderate | Suture,Prim,Torn Ligament,Ankle;Collater |
| 27696-CPT | Moderate | Rpair Primar Disrupted Ligamnt Ankle; Both Collateral Ligament, Repair Primary Disrupted Ligament Ankle; Both Collateral Ligaments |
| 27698-CPT | Moderate | Rpair Second Disrupted Ligamnt Ankle Collateral (Eg Watson-J, Repair Secondary Disrupted Ligament Ankle Collateral (Eg Watson-J |
| 27700-CPT | Moderate | Reshape Ankle Joint, Surgery To Reshape The Damaged End Of An Ankle Joint By Grinding Down The Surface. The Procedure Stimulates Growth Of New Tissue (Bone). |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 27695. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 27695 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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