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See a sample rate comparisonCPT 27407 Fee Schedule
Last Verified: September 2026
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.
Suture Cruciate Ligament Knee Prim
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 22 - On Campus Outpatient Hospital 24 - Ambulatory Surgical Center |
| Common Modifiers | None RT - Right side of body LT - Left side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 27407 |
| Medicaid Fee Schedule | View Medicaid rates for 27407 |
National average reimbursement for CPT 27407 by major payers:
$1,058.45
$1,065.32
$1,088.51
$1,301.89
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CPT 27407
5 of 25 sample ratesHigher to lower in this preview
Surgery Affiliate Of El Paso, LLC, Foundation Surgery Affiliate Of El Paso, LLC
Surgery Affiliate Of El Paso LLC
$18,079.00Published ratePotomac View Surgery Center, LLC
Potomac View Surgery Center LLC
$6,365.00Published ratePediatric And Adult Surgery Center Of Atlanta LLC
$3,844.00Published rateSouthwest Surgery Center LLC
$2,400.00Published rateAdvanced Eye Surgery Center, L.L.C.
Advanced Eye Surgery Center LLC
$819.00Published rate
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See a sample payer proposalCPT 27407 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 27407 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 27407 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 |
|---|---|---|
| 27405-CPT | Moderate | Suture Collat Ligament Knee Prim |
| 27407-CPT | High | Suture Cruciate Ligament Knee Prim |
| 27409-CPT | High | Rpair Primar Torn Ligamnt &/Or Capsule Knee Collateral R, Repair Primary Torn Ligament And/Or Capsule Knee; Collateral And Cr |
| 27425-CPT | Moderate | Release Lateral Retinacular Knee |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 27407. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 27407 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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