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See a sample rate comparisonCPT 27409 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.
Rpair Primar Torn Ligamnt &/Or Capsule Knee Collateral R, Repair Primary Torn Ligament And/Or Capsule Knee; Collateral And Cr
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 22 - On Campus Outpatient Hospital 21 - Inpatient Hospital |
| Common Modifiers | None RT - Right side of body LT - Left side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 27409 |
| Medicaid Fee Schedule | View Medicaid rates for 27409 |
National average reimbursement for CPT 27409 by major payers:
$1,366.58
$1,306.06
$1,324.26
$1,584.04
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CPT 27409
5 of 25 sample ratesHigher to lower in this preview
Ochsner Medical Center, Ochsner Outpatient Surgery Suite
Ochsner Clinic Foundation
$21,412.00Published rateMunster Specialty Surgery Center, LLC, Munster Specialty Surgery Center
Munster Specialty Surgery Center, LLC
$4,472.00Published rateSurgery Center Of Anaheim Hills, LLC
Surgery Center Of Anaheim Hills LLC
$2,500.00Published rateWenatchee Valley Hospital, Confluence Health Omak Asc
Wenatchee Valley Hospital
$1,657.00Published rateSuncoast Endoscopy Asc Lp, Sun Coast Endoscopy Center
Suncoast Endoscopy Asc Lp
$680.00Published rate
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See a sample payer proposalCPT 27409 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 27409 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 27409 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 27409. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 27409 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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