CPT 27253 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 • 23 - Emergency Room |
| Common Modifiers | • None • RT - Right side of body • LT - Left side of body |
| Complexity Level | High |
National average reimbursement for CPT 27253 by major payers:
$1,231.60
$1,276.65
$1,296.55
$1,576.87
| 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 27253 | ||||||
United | 27253 | $759.00 | 1144416587 - DIGESTIVE ENDOSCOPY CENTER LLC | 311508446 - (OH) DIGESTIVE ENDOSCOPY CENTER, LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27253 | $3500.00 | 1114196151 - SUMMIT AMBULATORY SURGICAL CENTER LLC | 522148280 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27253 | $1424.00 | 1730152869 - BEL AIR ENDOSCOPY ASC LLC, HARFORD ENDOSCOPY CENTER | 621827593 - (MD) BEL AIR ENDOSCOPY ASC LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27253 | $1500.00 | 1124277959 - CPM SURGERY CENTER 2, LLC | 263297791 - (GA) CPM SURGERY CENTER 2 LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27253 | $1257.00 | 1679602544 - TGH SURGERY CENTER AT MORSANI, LLC, TGH SURGERY CENTER | 812203868 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27253 | $1600.00 | 1619037066 - THE EL DORADO AR MULTISPECIALTY ASC LLC, SOUTH ARKANSAS SURGERY CENTER | 203954951 - (AR) THE EL DORADO AR MULTISPECIALTY ASC LLC | AR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27253 | $4339.00 | 1083176309 - SPICEWOOD SURGERY CENTER LLC, SPICEWOOD SURGERY CENTER | 834343089 - (TX) SPICEWOOD SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27253 | $1000.00 | 1164516084 - ENDOSCOPIC AMBULATORY SPECIALTY CENTER OF BAY RIDGE INC | 113530475 - (NY) ENDOSCOPIC AMBULATORY SPECIALTY CENTER OF BAY RIDGE, INC. | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27253 | $1525.00 | 1689624793 - SURGERY CENTER OF SOUTHWEST FLORIDA INC | 843798404 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27253 | $1300.00 | 1841284742 - KLEINERT KUTZ SURGERY CENTER, LLC | 352095662 - (IN) KLEINERT KUTZ SURGERY CENTER LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27253 | $1854.00 | 1992384739 - SURGERY CENTER OPERATIONS, LLC | 851921698 - (FL) SURGERY CENTER OPERATIONS LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27253 | $630.00 | 1366710741 - THE EYE PHYSICIANS OF PINELLAS, PA, LARGO AMBULATORY SURGERY CENTER | 593400241 - (FL) THE EYE PHYSICIANS OF PINELLAS, P.A. | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27253 | $6225.00 | 1306472063 - THE EMORY CLINIC INC, EMORY ENDOSCOPY CENTER AT DECATUR | 582030692 - EMORY UNIVERSITY | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27253 | $742.00 | 1821166521 - PHYSICIANS SURGERY CENTER LLC | 860936521 - (AZ) PHYSICIANS SURGERY CENTER LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27253 | $2300.00 | 1922211192 - VOORHEES SURGERY CENTER, LLC | 651203770 - (NJ) VOORHEES SURGERY CENTER 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 27253 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 27253 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 27253 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 |
|---|---|---|
| 27226-CPT | High | Open Tx Post/Ant Wall Fx W/Int Fix |
| 27227-CPT | High | Open Treatment Of Acetabular Fracture(S) Involving Anterior Or Posterior (One) Column, Or A Fracture Running Transversely Across The Acetabulum, With Internal Fixation |
| 27228-CPT | High | Open Treatment Of Acetabular Fracture(S) Involving Anterior And Posterior (Two) Columns Includes T-Fracture And Both Column Fracture With Complete Articular Detachment Or Single Column Or Transverse Fracture With Associated Acetabular Wall Fracture With Internal Fixation |
| 27253-CPT | High | Open Tx Hip Disloc Traum Wo Int Fix |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 27253. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 27253 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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