CPT 27269 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 • LT - Left side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 27269 |
National average reimbursement for CPT 27269 by major payers:
$1,609.83
$1,661.64
$1,711.97
$2,069.10
| 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 27269 | ||||||
United | 27269 | $1242.00 | 1356412894 - ROCKFORD ORTHOPEDIC SURGERY CENTER, LLC | 364513047 - (IL) ROCKFORD ORTHOPEDIC SURGERY CENTER, LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27269 | $420.00 | 1073601332 - LISA RENFRO SURGERY CENTER LLC | 43612312 - (MD) LISA RENFRO SURGERY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27269 | $773.00 | 1831280536 - EFFINGHAM SURGICAL PARTNERS LLC | 371409876 - (IL) EFFINGHAM SURGICAL PARTNERS, LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27269 | $794.00 | 1194437624 - WATAUGA SURGICAL PARTNERS PLLC | 862624496 - (TN) WATAUGA SURGICAL PARTNERS PLLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27269 | $1364.00 | 1962879932 - GUILFORD SURGERY CENTER LLC | 473071064 - (CT) GUILFORD SURGERY CENTER | CT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27269 | $605.00 | 1164414447 - EAST VALLEY ENDOSCOPY LLC | 870667809 - (AZ) EAST VALLEY ENDOSCOPY, PLLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27269 | $565.00 | 1215185335 - ASC DEVELOPMENT COMPANY, LLC | 203405773 - (MD) ASC DEVELOPMENT COMPANY LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27269 | $742.00 | 1558339424 - PREMIER SURGERY CENTER | 352206509 - (CA) PREMIPREMIER SURGERY CENTER | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27269 | $789.00 | 1750668190 - ELKHART DAY SURGERY, LLC, INSIGHT SURGERY CENTER | 800712220 - (IN) ELKHART DAY SURGERY LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27269 | $832.00 | 1770072803 - PACIFIC VASCUCARE SURGERY CENTER | 823288521 - (CA) PACIFIC VASCUCARE SURGERY CENTER | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27269 | $986.00 | 1679696157 - ORTHOPEDIC HEALTHCARE ANCILLARY SERVICES, LLC, SLOCUM AMBULATORY SURGERY CENTER | 770590285 - (OR) ORTHOPEDIC HEALTHCARE ANCILLARY SERVICES LLC | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27269 | $1179.00 | 1538461348 - THE OUTPATIENT CENTER, LLC, THE OUTPATIENT CENTER OF BOYNTON BEACH, LTD. D/B/A THE OUTPATIENT CENT | 650440864 - (FL) THE OUTPATIENT CENTER OF BOYNTON BEACH, LTD. | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27269 | $675.00 | 1205373057 - BAY AREA ASC LLC, AZURA SURGERY CENTER HOUSTON | 814821022 - (TX) BAY AREA ASC LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27269 | $1320.00 | 1306353586 - SDG CASTLE ROCK ENDOSCOPY CENTER | 823765778 - (CO) SDG CASTLE ROCK ENDOSCOPY CENTER, LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27269 | $1123.00 | 1356704027 - GLEN ECHO SURGERY CENTER, LLC | 474049838 - (MD) GLEN ECHO SURGERY CENTER LLC | MD | 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 27269 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 27269 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 27269 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 |
|---|---|---|
| 27240-CPT | High | Closed Treatment Of Intertrochanteric, Peritrochanteric, Or Subtrochanteric Femoral Fracture; With Manipulation, With Or Without Skin Or Skeletal Traction |
| 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) |
| 27248-CPT | High | Open Tx Clos/Op Greater Trochanteric Fx, |
| 27269-CPT | High | Optx Thigh Fx |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 27269. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 27269 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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