CPT 27470 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 27470 |
| Medicaid Fee Schedule | View Medicaid rates for 27470 |
National average reimbursement for CPT 27470 by major payers:
$1,556.22
$1,597.03
$1,688.71
$1,932.18
CPT 27470 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 27470 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 27470 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 |
|---|---|---|
| 27470-CPT | High | Rpair Nonunion Or Malunion Femur Distal To Head & Nck; W/O, Repair Nonunion Or Malunion Femur Distal To Head And Neck; Without |
| 27472-CPT | High | Repair Nonunion Or Malunion, Repair Nonunion Or Malunion Femur Distal To Head Andneck With Iliac Or Other Autogenous Bone Graft (Includes Obtaining Graft) |
| 27475-CPT | Moderate | Arrest Epiphyseal Any Mthod (Eg Epiphysiodes); Distal Femur, Arrest Epiphyseal Any Method (Eg Epiphysiodesis); Distal Femur |
| 27503-CPT | High | Treatment Of Thigh Fracture, Closed Treatment Of Supracondylar Or Transcondylar Femoral Fracture With Or Without Intercondylar Extension With Manipulation With Or Without Skin Or Skeletal Traction |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 27470. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 27470 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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