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 |
| Medicaid Fee Schedule | View Medicaid rates for 27248 |
National average reimbursement for CPT 27248 by major payers:
$1,030.15
$1,015.56
$1,049.01
$1,226.48
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
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 | Repair And Secure A Broken Hip, Surgery To Repair A Broken Hip. Pins Wires Or Rods May Hold The Bone Together. The End Of The Bone May Be Replaced With An Artificial Part. |
| 27244-CPT | High | Open Treatment Of Intertrochan, Open Treatment Of Intertrochanteric Pertrochanteric Orsubtrochanteric Femoral Fracture With Platescrew Type Implant With Or Without Cerclage |
| 27245-CPT | High | Open Treatment Of Intertrochan, Open Treatment Of Intertrochanteric Pertrochanteric Orsubtrochanteric Femoral Fracture With Intramedullary Implant With Or Without Interlocking Screws Andor Cerclage |
| 27248-CPT | High | Surgical Repair Of Broken Hip, Surgery To Repair A Broken Hip Bone (Greater Trochanter). Pins Wires Or Screws May Be Used To Hold The Bone Together. |
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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