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See a sample rate comparisonHealthcare providers use this code to document and receive reimbursement for visits that address high-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 | 21 - Inpatient Hospital 24 - Ambulatory Surgical Center 23 - Emergency Room |
| Common Modifiers | None FA - Left hand, thumb F5 - Right hand, thumb |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 20827 |
| Medicaid Fee Schedule | View Medicaid rates for 20827 |
National average reimbursement for CPT 20827 by major payers:

$2,635.71

$2,612.44

$2,537.67

$3,152.21
Choose a payer to see a sample of rates for CPT 20827.
The Surgery Center, LLC
Fm Endoscopy Center, LLC
May Street Surgi Center, LLC
Endoscopy Center Of Toms River LLC
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Rate Benchmarking
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonPayer Contract Negotiation
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 20827 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 20827 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 20827 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 |
|---|---|---|
| 20816-CPT | High | Replantation Digit Complete, Replantation Digit Excluding Thumb Includes Metacarpophalangeal Joint To Insertion Of Flexor Sublimis Tendon Complete Amputation |
| 20822-CPT | High | Replantation Digit Complete, Replantation Digit Excluding Thumb Includes Distal Tip To Sublimis Tendon Insertion Complete Amputation |
| 20827-CPT | High | Replant Thumb (Inclu Distal Tip To Mp Joint) Comple Amputa, Replantation Thumb (Includes Distal Tip To Mp Joint) Complete Amputa |
| 20924-CPT | Moderate | Tndon Grft From A Distanc (Eg Palmaris Toe Extenso Plantari), Tendon Graft From A Distance (Eg Palmaris Toe Extensor Plantaris) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 20827. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 20827 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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