CPT 27454 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 | • 21 - Inpatient Hospital • 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 27454 |
National average reimbursement for CPT 27454 by major payers:
$1,690.34
$1,750.81
$1,794.48
$2,160.01
| 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 27454 | ||||||
United | 27454 | $2800.00 | 1760991921 - COLUMBIA NEPHROLOGY ASSOCIATES PA | 570702722 - (SC) THE COLUMBIA NEPHROLOGY ASSOCIATES, P.A. | SC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27454 | $3712.00 | 1124125331 - AMBULATORY SURGERY ASSOCIATES, LLC, BROOKSIDE SURGERY CENTER | 383237596 - (MI) AMBULATORY SURGERY ASSOCIATES | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27454 | $3000.00 | 1740230523 - SARASOTA AMBULATORY SURGERY CENTER LTD, SARASOTA AMBULATORY SURGERY CENTER | 203686491 - (FL) SARASOTA AMBULATORY SURGERY CENTER LTD | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27454 | $4500.00 | 1588203723 - SOUTHWEST CARDIOVASCULAR INTERVENTIONAL CENTER, LLC | 832560085 - (AZ) SOUTHWEST CARDIOVASCULAR INTERVENTIONAL CENTER LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27454 | $1500.00 | 1396141545 - AXIS SURGERY CENTER LLC | 463623155 - (GA) AXIS SURGERY CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27454 | $14053.00 | 1346235058 - EAST MEQUON SURGERY CENTER LLC | 861075286 - (WI) EAST MEQUON SURGERY CENTER LLC | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27454 | $1900.00 | 1164478764 - SURGERY CENTER OF LAWTON PROFESSIONAL LLC | 731579076 - (OK) SURGERY CENTER OF LAWTON PROFESSIONAL LLC | OK | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27454 | $6365.00 | 1326114869 - EL PASO CENTER FOR GASTROINTESTINAL ENDOSCOPY, LLC | 201482218 - (TX) EL PASO CENTER FOR GASTROINTESTINAL ENDOSCOPY LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27454 | $4748.00 | 1487221404 - EYE SURGICAL SERVICES LLC, GATEWAY SURGERY CENTER | 834616432 - (MO) EYE SURGICAL SERVICES, LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27454 | $4704.00 | 1386882587 - BAYLOR SURGICARE AT GRANBURY LLC, BAYLOR SCOTT & WHITE SURGICARE-GRANBURY | 263896477 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27454 | $6588.00 | 1740328947 - ENDOSCOPY CONSULTANTS, LLC | 510425612 - (GA) ENDOSCOPY CONSULTANTS LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27454 | $6433.00 | 1689666596 - MENOMONEE FALLS AMBULATORY SURGERY CENTER, LLC | 391745697 - (WI) MENOMONEE FALLS AMBULATORY SURGERY CENTER | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27454 | $7888.00 | 1306263983 - GCSA AMBULATORY SURGERY CENTER, LLC, GASTROENTEROLOGY CONSULTANTS OF SAN ANTONIO NE | 611699459 - (TX) GCSA AMBULATORY SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27454 | $1760.00 | 1053835058 - CEI PHYSICIANS PSC LLC, CVP SURGERY CENTER | 311473421 - CINCINNATI EYE INSTITUTE | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27454 | $1750.00 | 1508857871 - MANATEE SURGICAL CENTER, LLC | 650826479 - (FL) MANATEE SURGICAL 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 27454 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 27454 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 27454 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 |
|---|---|---|
| 27448-CPT | High | Osteotmy,Femr,Shft/Supracndy;Wo Fix |
| 27450-CPT | High | Osteotomy Femur W Fixation Unilat |
| 27454-CPT | High | Osteotomy Femur Mult W Realignment |
| 27457-CPT | High | Osteotomy, Proximal Tibia, Including Fibular Excision Or Osteotomy (Includes Correction Of Genu Varus (Bowleg) Or Genu Valgus (Knock-Knee)); After Epiphyseal Closure |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 27454. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 27454 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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