CPT 27422 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-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 | • 22 - On Campus Outpatient Hospital • 24 - Ambulatory Surgical Center |
| Common Modifiers | • None • LT - Left side of body • RT - Right side of body |
| Complexity Level | Moderate |
National average reimbursement for CPT 27422 by major payers:
$937.56
$1,006.76
$1,072.90
$1,255.26
| 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 27422 | ||||||
United | 27422 | $3646.00 | 1053585125 - BJOSC, LLC, BONE & JOINT SURGERY CENTER | 300391378 - BJOSC LLC | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27422 | $3745.00 | 1003015843 - NORTHBAY PHYSICIAN'S SURGERY CENTER, L.L.C. | 203502901 - (CA) NORTHBAY PHYSICIANS SURGERY CENTER LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27422 | $3547.00 | 1679696157 - ORTHOPEDIC HEALTHCARE ANCILLARY SERVICES, LLC, SLOCUM AMBULATORY SURGERY CENTER | 770590285 - (OR) ORTHOPEDIC HEALTHCARE ANCILLARY SERVICES LLC | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27422 | $5020.00 | 1548203888 - NORTH VALLEY ORTHOPEDIC SURGERY CENTER LLC, THE ORTHOPEDIC SURGERY CENTER OF ARIZONA | 202684773 - (AZ) NORTH VALLEY ORTHOPEDIC SURGERY CENTER LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27422 | $4137.00 | 1972874907 - CAPITAL CITY SURGERY CENTER, LLC | 260804803 - (NC) CAPITAL CITY SURGERY CENTER LLC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27422 | $6506.00 | 1942617477 - CENTER FOR ENDOSCOPY LLC | 464958743 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27422 | $1600.00 | 1013096700 - CLEARER VISION, LLC, PERIMETER SURGERY CENTER | 621792483 - (TN) CLEARER VISION, LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27422 | $1210.00 | 1467032862 - MIDWEST EYE CONSULTANTS, P.C. | 351845786 - (IN) MIDWEST EYE CONSULTANTS, P.C. | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27422 | $819.00 | 1740424944 - GASTRO CARE, LLC | 263402953 - (OH) GASTRO CARE LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27422 | $2489.00 | 1013471754 - ADVANCED SURGERY CENTER OF LANCASTER, LLC | 831133719 - (PA) ADVANCED SURGERY CENTER OF LANCASTER LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27422 | $4635.00 | 1083670970 - GLENWOOD SURGICAL CENTER L P | 330595220 - (CA) GLENWOOD SURGICAL CENTER LP | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27422 | $16929.00 | 1295887727 - TEXAS HEALTH PRESBYTERIAN HOSPITAL DALLAS | 751047527 - (TX) TEXAS HEALTH PRESBYTERIAN HOSPITAL DALLAS | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27422 | $2306.00 | 1669540118 - STEVENS KIM MD AND STEPHEN LIN MD MEDICAL GROUP INC, VALLEY LASER SURGERY CENTER, INC. | 203111961 - (CA) STEVENS KIM MD AND STEPHEN LIN MD MEDICAL GROUP INC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27422 | $3600.00 | 1851467740 - WIREGRASS RANCH ASC HOLDINGS, WIREGRASS RANCH SPECIAL PROCEDURES CENTER | 991010158 - (FL) WIREGRASS RANCH ASC HOLDINGS | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27422 | $4456.00 | 1962435990 - NORTHERN MONMOUTH REGIONAL SURGERY CENTER LLC, CENTER FOR BONE AND JOINT SURGERY | 201026094 - (NJ) NORTHERN MONMOUTH REGIONAL 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 |
Want to see your competitors' rates?
Start your trial today to unlock complete access to provider rates and fee schedules in your area.
Here's what you can do with PayerPrice
Renegotiate your managed care contracts
Benchmark your current rates against market averages to identify opportunities for rate optimization.
Prospect for new business using fee schedules
Access every provider's negotiated rates for every billing code in your market to inform your prospecting strategies.
Integrate real-time payer data into your workflows
Automatically keep fee schedules up-to-date without adding yet another log-in to your insurance systems. Connect via API or SQL.
PayerPrice shows you the exact negotiated rates that insurers publish under federal transparency rules.
We display the raw data directly from insurers' files, giving you the same information they make public. Learn more about Price Transparency.
CPT 27422 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 27422 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 27422 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 |
|---|---|---|
| 27412-CPT | High | Autologous Chondrocyte Implantation, Knee |
| 27418-CPT | High | Rep Ant Tibial Tubercule (Maquet) |
| 27420-CPT | High | Reconstr.-Recurrent Disloc.Patella; |
| 27422-CPT | Moderate | Reconstruction Of Dislocating Patella; With Extensor Realignment And/Or Muscle Advancement Or Release (Eg, Campbell, Goldwaite Type Procedure) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 27422. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 27422 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.
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 27422) and we'll show you how you compare in 15 minutes or less.