How much does Medicare pay for CPT 27279?

Medicare allowed an average of $5445.92 per service and paid $4336.94 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $21,498, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 27279?

Fusion of pelvic joint using imaging guidance. It was billed 3,316 times to 3,002 Medicare beneficiaries by 172 providers in 2024.

Which specialty bills 27279 most?

Ambulatory Surgical Center, with 1,181 services from 59 clinicians. Next are Orthopedic Surgery, Neurosurgery, Physician Assistant.

CPT 27279

Fusion of pelvic joint using imaging guidance

$5445.92Medicare-allowed amount per service, averaged across 3,316 services

Providers submitted

$21,498

Asking price, not received

Medicare allowed

$5445.92

The fee schedule figure

Medicare paid

$4336.94

Balance is patient coinsurance

Providers submitted an average of $21,498 for this code and Medicare allowed $5445.92 — 3.9× 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 $4336.94 (80%); the rest is the patient’s coinsurance and deductible.

Services: 3,316
Beneficiaries: 3,002
Providers billing it: 172
Total allowed: $18,058,671

What Medicare pays for CPT 27279

Across 3,316 services billed by 172 providers to 3,002 beneficiaries, Medicare allowed an average of $5445.92 per service. 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 27279

Specialty	Services	Beneficiaries	Avg allowed	Providers
Ambulatory Surgical Center	1,181	1,023	$14,170	59
Orthopedic Surgery	729	692	$797.04	35
Neurosurgery	414	383	$800.46	23
Physician Assistant	413	397	$112.62	22
Interventional Pain Management	149	118	$787.94	7
Pain Management	131	119	$760.65	7
Nurse Practitioner	118	106	$99.89	7
Anesthesiology	118	108	$770.57	9
Physical Medicine and Rehabilitation	35	31	$732.77	1
Diagnostic Radiology	28	25	$708.66	2

27279 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
Texas	577	$5848.31	$4863.44	28
California	451	$8688.08	$5755.93	24
Florida	436	$5217.35	$4435.44	20
Georgia	213	$3899.96	$3355.23	11
Washington	186	$4160.45	$3172.35	10
Arizona	168	$4955.07	$4078.36	9
South Carolina	125	$3497.78	$3001.56	4
Oklahoma	109	$521.82	$438.68	6
Minnesota	104	$3452.03	$2796.53	4
Mississippi	102	$4938.05	$4494.97	5
Utah	73	$4502.90	$3719.38	3
Pennsylvania	70	$6504.93	$5557.55	5
Oregon	68	$7973.55	$6622.37	3
North Dakota	68	$3953.05	$3596.31	4
Ohio	62	$4324.40	$3828.33	4
Michigan	59	$8302.90	$7028.94	4
Kansas	54	$5557.67	$4640.10	3
Indiana	49	$5983.72	$5356.78	3
New Hampshire	46	$450.01	$351.57	2
Missouri	46	$9445.22	$8273.05	3
Wisconsin	44	$5053.95	$4408.46	3
Colorado	39	$563.25	$444.17	3
Illinois	33	$604.57	$446.62	2
Tennessee	30	$701.98	$610.91	2
Maryland	23	$14,643	$11,526	1
South Dakota	22	$6922.83	$6077.93	2
North Carolina	18	$14,157	$11,527	1
New Jersey	16	$15,321	$11,527	1
Arkansas	14	$731.21	$639.24	1
Montana	11	$1012.42	$801.53	1

Related codes

27245Treatment of broken neck of thigh bone$1034.24
27236Treatment of upper end of broken thigh bone$983.38
27280Fusion of sacroiliac joint between spine and pelvis$1317.55

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.