How much does Medicare pay for CPT 27095?

Medicare allowed an average of $162.03 per service and paid $125.99 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $984.49, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 27095?

Injection of contrast for imaging of hip under anesthesia. It was billed 1,075 times to 880 Medicare beneficiaries by 44 providers in 2024.

Does 27095 pay differently in an office than a hospital?

Yes. The allowed amount averaged $312.00 in an office setting and $79.03 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 27095 most?

Orthopedic Surgery, with 559 services from 24 clinicians. Next are Pain Management, Interventional Pain Management, Diagnostic Radiology.

CPT 27095

Injection of contrast for imaging of hip under anesthesia

$162.03Medicare-allowed amount per service, averaged across 1,075 services

Providers submitted

$984.49

Asking price, not received

Medicare allowed

$162.03

The fee schedule figure

Medicare paid

$125.99

Balance is patient coinsurance

Providers submitted an average of $984.49 for this code and Medicare allowed $162.03 — 6.1× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $125.99 (78%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $312.00
Hospital / facility: $79.03

The office rate is higher because the practice supplies the room, staff and equipment out of that payment. In a hospital the facility bills those separately, so the clinician's share is smaller — the total cost to Medicare is usually higher, not lower. 383 services were billed in an office setting and 692 in a facility.

Services: 1,075
Beneficiaries: 880
Providers billing it: 44
Total allowed: $174,182

What Medicare pays for CPT 27095

Across 1,075 services billed by 44 providers to 880 beneficiaries, Medicare allowed an average of $162.03 per service. That is 1.2 services per beneficiary, so this is a code patients typically receive more than once. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 27095

Specialty	Services	Beneficiaries	Avg allowed	Providers
Orthopedic Surgery	559	483	$77.34	24
Pain Management	165	144	$188.22	7
Interventional Pain Management	130	53	$327.72	2
Diagnostic Radiology	91	85	$289.05	3
Anesthesiology	80	68	$279.84	5
Physical Medicine and Rehabilitation	50	47	$171.97	3

27095 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
California	179	$229.04	$167.56	6
Texas	157	$98.43	$78.44	6
Florida	153	$307.46	$246.65	5
Michigan	146	$87.62	$62.11	7
Pennsylvania	114	$264.43	$199.61	6
Oklahoma	74	$74.86	$68.49	3
New York	71	$59.04	$38.80	3
Maryland	66	$82.68	$60.43	1
Indiana	29	$75.10	$58.16	2
Kansas	21	$74.39	$55.60	1
Louisiana	19	$294.93	$263.17	1
New Jersey	17	$89.48	$64.76	1
Iowa	15	$77.20	$60.44	1
Georgia	14	$38.80	$31.64	1

Related codes

27096Injection of anesthetic or steroid into joint between lower spine and$149.42
27093Injection of contrast for imaging of hip joint$216.38

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.