CPT 27248 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 • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • RT - Right side of body • 59 - Distinct Procedural Service |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 27248 |
National average reimbursement for CPT 27248 by major payers:
$1,030.15
$1,015.56
$1,049.01
$1,253.90
| 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 27248 | ||||||
United | 27248 | $3926.00 | 1932782315 - WAKE SPINE AND SPECIALTY SURGERY CENTER LLC, RALEIGH NEUROSURGICAL AND SPINE SURGERY CENTER | 842694789 - (NC) WAKE SPINE & SPECIALTY SURGERY | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27248 | $3850.00 | 1669586376 - JEFFERSON AMBULATORY SURGERY CENTER LLC | 202349222 - (LA) JEFFERSON AMBULATORY SURGERY C | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27248 | $3500.00 | 1508528910 - CHEROKEE FARM ORTHOPEDIC SURGERY CENTER, LLC | 850654744 - (TN) CHEROKEE FARM ORTHOPEDIC SURGERY CENTER LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27248 | $970.00 | 1659903292 - RACINE DIGESTIVE HEALTH CENTER LLC | 844211105 - (WI) RACINE DIGESTIVE HEALTH CENTER LLC | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27248 | $6492.00 | 1861740508 - ADVANCED SURGERY CENTER OF SARASOTA, LLC | 454909647 - (FL) ADVANCED SURGERY CENTER OF SARASOTA LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27248 | $6087.00 | 1750565594 - PEDIATRIC SURGERY CENTER -ODESSA, LLC | 651274446 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27248 | $3811.00 | 1548226442 - ARTHROSCOPIC & LASER SURGERY CENTER OF SAN DIEGO LP | 631166884 - (CA) ARTHROSCOPIC & LASER SURGERY CENTER OF SAN DIEGO, LP | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27248 | $6588.00 | 1093086183 - CHANDLER ENDOSCOPY AMBULATORY SURGERY CENTER, LLC, CHANDLER ENDOSCOPY CENTER | 454307241 | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27248 | $3677.00 | 1861492530 - GRANTS PASS SURGERY CENTER, LLC | 931237063 - (OR) GRANTS PASS SURGERY CENTER, LLC | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27248 | $3300.00 | 1083955330 - BELLEVUE PLASTIC SURGERY CENTER, NEWVUE PLASTIC SURGERY PC | 263374369 - (WA) NEWVUE PLASTIC SURGERY, PC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27248 | $3250.00 | 1972535292 - CATARACT AND LASER SURGERY CENTER, THE OPHTHALMOLOGY & SURGICAL INSTITUTE OF CENTRAL PA | 201308496 - (PA) CATARACT AND LASER SURGERY CENTER | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27248 | $4641.00 | 1144283649 - SKY RIDGE SURGERY CENTER LP | 223877040 - (CO) SKY RIDGE SURGERY CENTER LP | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27248 | $1705.00 | 1952464844 - EDWARDSVILLE AMBULATORY SURGERY CENTER LLC | 371343371 - (IL) EDWARDSVILLE AMBULATORY SURGERY CENTER LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27248 | $2041.00 | 1235105248 - GURLEY SURGERY CENTER, THE GYN CENTER | 621159796 - (TN) GURLEY SURGERY CENTER | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27248 | $1562.00 | 1053301473 - BAKER AMBULATORY SURGERY CENTER | 710839283 - (AR) BAKER AMBULATORY SURGERY CENTER | AR | 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 27248 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 27248 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 27248 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 |
|---|---|---|
| 27236-CPT | High | Open Tx Fem Fx Int Fix/Prosth Repla |
| 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 |
| 27248-CPT | High | Open Tx Clos/Op Greater Trochanteric Fx, |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 27248. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 27248 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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