CPT 20827 Fee Schedule
Healthcare 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 |
National average reimbursement for CPT 20827 by major payers:
$2,635.71
$2,612.44
$2,537.67
$3,152.21
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 20827 | ||||||
United | 20827 | $1792.00 | 1639176183 - BERKS CENTER FOR DIGESTIVE HEALTH, LP | 233068912 | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20827 | $7410.00 | 1982942298 - STOCKTON OUTPATIENT SURGERY CENTER LLC, AMBULATORY SURGERY CENTER OF STOCKTON | 371709575 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20827 | $3077.00 | 1093079196 - MERCY HOSPITALS EAST COMMUNITIES, MERCY OUTPATIENTSURGERY CENTER WASHINGTON | 431066883 - (MO) MERCY HOSPITALS EAST COMMUNITIES | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20827 | $1485.00 | 1821336371 - EYECARE SURGERY CENTER, LLC | 461073660 - (MS) EYECARE SURGERY CENTER LLC | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20827 | $3400.00 | 1992999775 - SPINE SURGERY CENTER OF EUGENE, LLC | 203303351 - (OR) SPINE SURGERY CENTER OF EUGENE LLC | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20827 | $2796.00 | 1720606932 - PHYSICIANS CLINIC INC | 470687317 - PHYSICIANS CLINIC INC | NE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20827 | $935.00 | 1043275183 - FOREST AMBULATORY SURGICAL ASSOCIATES LLC, FOREST SURGERY CENTER | 942934248 - (CA) FOREST AMBULATORY SURGICAL ASSOCIATES, LP | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20827 | $6492.00 | 1205949245 - MEMORIAL SURGERY CENTER, LLC | 201167151 - (OK) MEMORIAL SURGERY CENTER LLC | OK | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20827 | $1078.00 | 1972556942 - CHERRY HILL WOMEN'S CENTER, INC. | 232068660 - (NJ) CHERRY HILL WOMENS CENTER INC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20827 | $5500.00 | 1326144221 - FM ENDOSCOPY CENTER LLC, CENTER FOR SPECIAL SURGERY | 364810414 - (ND) FM ENDOSCOPY CENTER, LLC | ND | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20827 | $3000.00 | 1952834277 - AMERICAN ACCESS CARE OF TOWSON ASC LLC | 814571016 - (MD) AMERICAN ACCESS CARE OF TOWSON ASC LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20827 | $3061.00 | 1932164852 - MAY STREET SURGI CENTER, LLC, MAY STREET SURGI CENTER | 223777533 - (NJ) MAY STREET SURGI CENTER, LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20827 | $3000.00 | 1043204688 - INDIANA AMBULATORY SURGICAL ASSOCIATES, INC | 232923182 - (PA) INDIANA AMBULATORY SURGICAL ASSOCIATES INC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20827 | $851.00 | 1922237213 - ENDOSCOPY CENTER OF TOMS RIVER, LLC | 300568338 - (NJ) ENDOSCOPY CENTER OF TOMS RIVER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20827 | $6492.00 | 1366449571 - SHORE OUTPATIENT SURGICENTER LLC | 582252127 - (NJ) SHORE OUTPATIENT SURGICENTER LLC | NJ | 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 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, Excluding Thumb (Includes Metacarpophalangeal Joint To Insertion Of Flexor Sublimis Tendon), Complete Amputation |
| 20822-CPT | High | Replant Digit Tip To Flex Sublimis Compl |
| 20827-CPT | High | Replant Thumb Tip To Mp Complete Amp |
| 20924-CPT | Moderate | Tendon Graft From Distance |
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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