CPT 27424 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 | • 22 - On Campus Outpatient Hospital • 24 - Ambulatory Surgical Center |
| Common Modifiers | • None • LT - Left side of body • RT - Right side of body |
| Complexity Level | High |
National average reimbursement for CPT 27424 by major payers:
$1,024.89
$1,011.48
$1,046.96
$1,262.67
| 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 27424 | ||||||
United | 27424 | $3253.00 | 1003887225 - CENTRAL TEXAS ENDOSCOPY CENTER LLC, CENTRAL TEXAS ENDOSCOPY CENTER | 742863853 - (TX) CENTRAL TEXAS ENDOSCOPY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27424 | $3637.00 | 1316924632 - CAROLINA BONE & JOINT SURGERY CENTER | 134241163 - (SC) CAROLINA BONE & JOINT SURGERY | SC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27424 | $1425.00 | 1588735708 - FILUTOWSKI EYE INSTITUTE PA, LAKE MARY SURGICAL CENTER | 593111497 - (FL) FILUTOWSKI EYE INSTITUTE, P.A. | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27424 | $730.00 | 1295824100 - BETTER LIVING ENDOSCOPY CENTER | 640877920 - (MS) BETTER LIVING ENDOSCOPY CENTER | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27424 | $2738.00 | 1326710401 - TEXAS INSTITUTE OF SPECIALIZED SURGERY, LLC, LEGENT INSTITUTE FOR SPECIALIZED SUGERY | 872851699 - (TX) TEXAS INSTITUTE OF SPECIALIZED SURGERY LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27424 | $2250.00 | 1669931861 - UROLOGY HEALTH SURGERY CENTER, LLC, UROLOGY HEALTH SURGERY CENTER, LLC | 260412126 - (PA) UROLOGY HEALTH SURGERY CENTER LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27424 | $1983.00 | 1073588646 - ESCONDIDO CA ENDOSCOPY ASC LP, PARKWAY ENDOSCOPY CENTER | 201627039 - (CA) ESCONDIDO CA ENDOSCOPY ASC LP | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27424 | $5433.00 | 1093985525 - SURGERY CENTER OF CORAL GABLES LLC, CORAL GABLES SURGERY CENTER | 204843518 - (FL) SURGERY CENTER OF CORAL GABLES LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27424 | $1420.00 | 1487625802 - PERIMETER CENTER FOR OUTPATIENT SURGERY LP | 581978405 - (GA) PERIMETER CENTER FOR OUTPATIENT SURGERY LP | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27424 | $1200.00 | 1417333295 - IDOX3 LLC, TRI-STATE SURGERY CENTER | 473757893 - (OH) IDOX3 LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27424 | $2200.00 | 1942956123 - METROLINA VASCULAR ACCESS CARE LLC | 831967528 - (NC) METROLINA VASCULAR ACCESS CARE LLC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27424 | $5433.00 | 1184125809 - SUMMIT AMBULATORY SURGICAL CENTER LLC | 522148280 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27424 | $835.00 | 1932190170 - OCALA EYE SURGERY CENTER INC | 593323478 - (FL) OCALA EYE SURGERY CENTER INC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27424 | $1337.00 | 1710032842 - MSC AMBULATORY SURGICAL CENTER | 202155076 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27424 | $3275.00 | 1811546575 - FIRST COAST ORTHOPEDIC CENTER, LLC, FIRST COAST SURGERY CENTER | 822929226 - (FL) FIRST COAST ORTHOPEDIC CENTER LLC | FL | 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 27424 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 27424 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 27424 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 |
|---|---|---|
| 27350-CPT | Moderate | Patellectomyor Hemipatellectomy |
| 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) |
| 27424-CPT | High | Reconst.Disloc.Patella;Patellectomy |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 27424. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 27424 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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