CPT 27246 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 | • 21 - Inpatient Hospital • 11 - Office • 23 - Emergency Room |
| Common Modifiers | • None • RT - Right side of body • LT - Left side of body |
| Complexity Level | Moderate |
National average reimbursement for CPT 27246 by major payers:
$543.78
$520.90
$541.67
$657.66
| 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 27246 | ||||||
United | 27246 | $574.00 | 1568967131 - CENTRAL MAINE EYE SURGERY CENTER LLC | 824811437 - (ME) CENTRAL MAINE EYE SURGERY CENTER LLC | ME | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27246 | $375.00 | 1922211192 - VOORHEES SURGERY CENTER, LLC | 651203770 - (NJ) VOORHEES SURGERY CENTER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27246 | $94.00 | 1154318376 - LAHAYE CENTER FOR ADVANCED EYE CARE OF LAFAYETTE, INC. | 721227426 | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27246 | $5213.00 | 1356124309 - SAINT LUKE'S NORTH SURGERY CENTER, LLC | 920591506 - (MO) SAINT LUKES NORTH SURGERY CENTER LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27246 | $566.00 | 1881969269 - SURGERY CENTRE OF SW FLORIDA LLC, CAPE HEALTH SURGERY CENTER | 454068750 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27246 | $150.00 | 1679595680 - SURGERY CENTER OF LEBANON, LP, PHYSICIANS SURGICAL CENTER | 721588584 - (PA) SURGERY CENTER OF LEBANON LP | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27246 | $359.00 | 1386748440 - COAST CENTER FOR ORTHOPEDIC AND ARTHROSCOPIC SURGERY LLC, SHARP SAN DIEGO SURGERY CENTER | 330839637 - (CA) COAST CENTER FOR ORTHOPEDIC AND ARTHROSCOPIC SURGERY, LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27246 | $1032.00 | 1841234150 - HINSDALE SURGICAL CENTER, LLC | 362276984 - ADVENTIST MIDWEST HEALTH | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27246 | $250.00 | 1780117440 - INSIGHT SURGERY CENTER, LLC | 813772336 - (CO) INSIGHT SURGERY CENTER LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27246 | $240.00 | 1255809620 - PRAIRIE ORTHOPAEDIC & PLASTIC SURGERY, P.C. | 208397360 - (NE) PRAIRIE ORTHOPAEDIC & PLASTIC SURGERY, P.C. | NE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27246 | $95.00 | 1073079596 - PREMIER GASTROENTEROLOGY ASSOCIATES PLLC, PREMIER SURGERY CENTER | 824134212 - (AR) PREMIER GASTROENTEROLOGY ASSOCIATES, PLLC | AR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27246 | $102.00 | 1104857523 - SURGERY CENTER OF ST. JOSEPH, LLC | 371439847 - (MO) SURGERY CENTER OF ST JOSEPH LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27246 | $50.00 | 1043284508 - WINTER HAVEN-SEBRING FL OPHTHALMOLOGY ASC LLC, EYE SURGERY & LASER CENTER OF SEBRING | 743072437 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27246 | $150.00 | 1427545540 - ORBIS SURGERY CENTER LLC | 825184428 - (TX) ORBIS SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27246 | $566.00 | 1538773890 - ASC OF TRINITY, COMPREHENSIVE OUTPATIENT JOINT AND SPINE INSTITUTE | 833008593 - (FL) ASC OF TRINITY | FL | 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 27246 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 27246 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 27246 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 |
|---|---|---|
| 27238-CPT | Moderate | Treat Fx-Inter/Pertrochanteric |
| 27244-CPT | High | Treatment Of Intertrochanteric Pertrochanteric Or Subtrochanteric Femoral Fracture; With Plat E/Screw Type Implant With Or Without Cerclage (Desc Rev 1/1/03) |
| 27245-CPT | High | Open Treatment Of Intertrochanteric Pertrochanteric Or Subtrochanteric Femoral Fracture; With Intramedullary Implant With Or Without Interlocking Screws And/Or Cerclage |
| 27246-CPT | Moderate | Clo Tx Greater Troch Fx Wo Manip |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 27246. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 27246 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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