CPT 27202 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 • 21 - Inpatient Hospital |
| Common Modifiers | • None • SG - Scene to Hospital ESRD facility • AS - PA/NP/CNS assistant at surgery |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 27202 |
National average reimbursement for CPT 27202 by major payers:
$741.83
$800.19
$750.18
$954.62
| 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 27202 | ||||||
United | 27202 | $3489.00 | 1568918746 - ORTHOPEDIC SURGERY CENTER OF PALM BEACH COUNTY, LLC | 812594417 - (FL) ORTHOPEDIC SURGERY CENTER OF PALM BEACH COUNTY LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27202 | $5262.00 | 1841444593 - TEANECK SURGICAL CENTER, LLC | 10776897 - (NJ) TEANECK SURGICAL CENTER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27202 | $6588.00 | 1649515354 - SURGCENTER NORTHEAST LLC | 455554995 - (FL) SURGCENTER NORTHEAST, LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27202 | $3864.00 | 1407046436 - NORTHWOODS SURGERY CENTER, LLC | 260434501 - (WI) NORTHWOODS SURGERY CENTER LLC | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27202 | $3413.00 | 1598847139 - ORTHOPAEDIC ASSOCIATES SURGERY CENTER, LLC | 582623564 - (GA) ORTHOPAEDIC ASSOCIATES SURGERY CTR, LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27202 | $905.00 | 1043284508 - WINTER HAVEN-SEBRING FL OPHTHALMOLOGY ASC LLC, EYE SURGERY & LASER CENTER OF SEBRING | 743072437 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27202 | $3500.00 | 1275647901 - PERMIAN BASIN SURGICAL CARE CENTER, LLC, VISTA SURGERY CENTER | 830343238 - (TX) PERMIAN BASIN SURGICAL CARE CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27202 | $4822.00 | 1386190957 - HOLLY SPRINGS SURGERY CENTER, LLC | 473460976 - (NC) HOLLY SPRINGS SURGERY CENTER LLC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27202 | $2000.00 | 1205978780 - MOUNTAIN HOME SURGERY CENTER | 454157268 | AR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27202 | $1815.00 | 1023071180 - SAHARA OUTPATIENT SURGERY CENTER LTD | 752509486 - (NV) SAHARA OUTPATIENT SURGERY CENTER LTD | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27202 | $1044.00 | 1407247208 - COLONOSCOPY AND ENDOSCOPY CENTER LLC | 471628673 - (OH) COLONOSCOPY AND ENDOSCOPY CENTER LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27202 | $7888.00 | 1396211264 - PALM BEACH SURGICAL SUITES LLC | 830558319 - (FL) PALM BEACH SURGICAL SUITES LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27202 | $982.00 | 1285065490 - MASON ESC, LLC, MASON EYE SURGERY CENTER | 462015301 - (NY) MASON ESC LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27202 | $6835.00 | 1568244192 - TOWER CLOCK SURGERY CENTER APPLETON, LLC | 921425291 - (WI) TOWER CLOCK SURGERY CENTER APPLETON LLC | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27202 | $1500.00 | 1356672919 - CPMSC ROSWELL, LLC | 271697405 - (GA) CPMSC ROSWELL LLC | 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 27202 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 27202 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 27202 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 |
|---|---|---|
| 27080-CPT | Moderate | Coccygectomy Primary |
| 27197-CPT | Low | Closed Treatment Of Posterior Pelvic Ring Frac- Ture(S) Dislocation(S) Diastasis Or Subluxation Of The Ilium Sacroiliac Joint And/Or Sacrum With Or Without Anterior Pelvic Ring Fracture(S) And/Or Dislocation(S) Of The Pubic Symphysis And/ Or Superior/Inferior Rami Unilateral Or Bila- Teral; Without Manipulation |
| 27200-CPT | Moderate | Closed Tx Coccygcal Fracture |
| 27202-CPT | Moderate | Open Treatment Coccygeal Fracture |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 27202. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 27202 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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