CPT 27466 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 • LT - Left side of body • RT - Right side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 27466 |
National average reimbursement for CPT 27466 by major payers:

$1,569.04

$1,603.25

$1,680.75

$1,982.84
| 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 27466 | ||||||
United | 27466 | $1818.00 | 1710952130 - MARYLAND ENDOSCOPY CENTER LLC, MARYLAND ENDOSCOPY CENTER | 521888989 - (MD) MARYLAND ENDOSCOPY CENTER, LLC. | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27466 | $1950.00 | 1598068306 - EXECUTIVE PARK SURGERY CENTER OF FORT SMITH, INC | 273053996 | AR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27466 | $4030.00 | 1629320742 - DENVER WEST ENDOSCOPY CENTER, LLC | 460788218 - (CO) DENVER WEST ENDOSCOPY CENTER LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27466 | $2121.00 | 1477516532 - SPECIALTY SURGICARE OF LAS VEGAS, LP | 260116160 | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27466 | $695.00 | 1144293309 - SUNCOAST ENDOSCOPY ASC LP, SUN COAST ENDOSCOPY CENTER | 621839179 - (FL) SUNCOAST ENDOSCOPY ASC LP | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27466 | $3118.00 | 1467016055 - HARBIN CLINIC, LLC, HARBIN CLINIC GI LAB CARTERSVILLE | 582234927 - (GA) THE HARBIN CLINIC, L.L.C. | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27466 | $3339.00 | 1730374307 - NORTHVIEW ORTHOPAEDIC SURGERY CENTER, P.C. | 261245423 - (GA) NORTHVIEW ORTHOPAEDIC SURGERY CENTER PC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27466 | $5846.00 | 1023604931 - ADVANCED SPINE AND PAIN SURGERY CENTERS LLC | 854282481 - (AZ) ADVANCED SPINE AND PAIN SURGERY CENTERS LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27466 | $6087.00 | 1386277069 - SOUTHWEST ENDOSCOPY LLC | 843623972 | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27466 | $5000.00 | 1245759356 - DALLAS ASC, LLC, NORTH PARK HEART & VASCULAR SURGERY CENTER | 823468320 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27466 | $675.00 | 1215919329 - GASTRO-INTESTINAL CENTER INC | 710676674 - (AR) GASTROINTESTINAL CENTER INC | AR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27466 | $4000.00 | 1487117370 - LIBERTY CORNER SURGICAL CENTER LLC | 833879253 - (NJ) LIBERTY CORNER SURGICAL CENTER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27466 | $3614.00 | 1588711162 - SEATTLE HAND SURGERY GROUP PC, SEATTLE HAND SURGERY UNIT, INC | 911652268 - (WA) SEATTLE HAND SURGERY GROUP, P.C. | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27466 | $2121.00 | 1194790592 - UPMC HAMOT SURGERY CENTER, LLC | 251863661 - (PA) UPMC HAMOT SURGERY CENTER, L.L.C. | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27466 | $1813.00 | 1598700676 - FLORIDA EYE INSTITUTE SURGICENTER LLC | 134232690 - (FL) FLORIDA EYE INSTITUTE SURGICENTER 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 27466 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 27466 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 27466 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.
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 27466. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 27466 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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