CPT 27412 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 | • 24 - Ambulatory Surgical Center • 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 27412 |
National average reimbursement for CPT 27412 by major payers:
$2,208.47
$2,230.68
$2,352.20
$2,763.41
| 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 27412 | ||||||
United | 27412 | $2043.00 | 1164469086 - SAME DAY SURGICARE OF NEW ENGLAND, INC., SAME DAY SURGICLINIC | 42808359 - (MA) SAME DAY SURGICARE OF NEW ENGLAND, INC. | MA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27412 | $2528.00 | 1063996734 - COASTAL ENDO, LLC, COASTAL ENDOSCOPY CENTER | 831370400 | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27412 | $6588.00 | 1053453134 - ADVANCED SURGICAL CONCEPTS LLC | 331035210 - (LA) ADVANCED SURGICAL CONCEPTS LLC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27412 | $4012.00 | 1578980421 - SUNSET RIDGE SURGERY CENTER, LLC | 463505336 - (NV) SUNSET RIDGE SURGERY CENTER, LLC | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27412 | $4394.00 | 1437106846 - ANTIETAM UROSURGICAL CENTER LLC ASC | 522006832 - (MD) ANTIETAM UROSURGICAL CENTER LLC ASC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27412 | $4072.00 | 1801450986 - DOCTORS HOSPITAL, INC, BAPTIST HEALTH SURGERY CENTER CORAL GABLES | 43775926 - (FL) DOCTORS HOSPITAL INC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27412 | $6303.00 | 1184686164 - SHORE AMBULATORY SURGICAL CENTER, LLC | 223778333 - (NJ) SHORE AMBULATORY SURGICAL CENTER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27412 | $2855.00 | 1801443320 - ST. LUKE'S SURGERY CENTER OF CHESTERFIELD, LLC | 384106846 - (MO) ST LUKES SURGERY CENTER OF CHESTERFIELD LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27412 | $1297.00 | 1891071072 - ST. CHARLES SURGERY CENTER | 275109874 - (MO) ST. CHARLES SURGERY CENTER, LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27412 | $7666.00 | 1164776266 - UNIVERSITY OF KANSAS HOSPITAL | 481202402 - UNIVERSITY OF KANSAS HOSPITAL AUTHORITY | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27412 | $6492.00 | 1043803877 - PALM BEACH INTERNATIONAL SURGERY CENTER LLC, PALM BEACH INTERNATIONAL SURGERY CENTER AT THE PALEY INSTITUTE | 384092545 - (FL) PALM BEACH INTERNATIONAL SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27412 | $1508.00 | 1437100666 - HEARTLAND CATARACT & LASER SURGERY CENTER, INC., HEARTLAND CATARACT & LASER SURGERY CENTER | 470824936 - (NE) HEARTLAND CATARACT LASER SURGERY CENTER INC | NE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27412 | $729.00 | 1871841544 - SPALDING ENDOSCOPY CENTER, LLC | 453051061 - (GA) SPALDING ENDOSCOPY CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27412 | $4060.00 | 1225452303 - MARTHA JEFFERSON HOSPITAL, MARTHA JEFFERSON OUTPATIENT SURGERY CENTER | 540261840 - (VA) MARTHA JEFFERSON HOSPITAL | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27412 | $515.00 | 1760778765 - GASTROINTESTINAL DIAGNOSTIC ENDOSCOPY WOODSTOCK, LLC, TOWN LAKE ENDOSCOPY CENTER | 274193796 - (GA) GASTROINTESTINAL DIAGNOSTIC ENDOSCOPY WOODSTOCK LLC | GA | 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 27412 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 27412 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 27412 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 |
|---|---|---|
| 27364-CPT | High | Radical Resection Of Tumor (Eg Sarcoma) Soft Tissue Of Thigh Or Knee Area; 5 Cm Or Greater (Revised 01/01/2014) |
| 27405-CPT | Moderate | Suture Collat Ligament Knee Prim |
| 27409-CPT | High | Suture Collat + Cruciate Lig Prim |
| 27412-CPT | High | Autologous Chondrocyte Implantation, Knee |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 27412. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 27412 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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