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See a sample rate comparisonCPT 27472 Fee Schedule
Medicare rates as of October 2026
CPT 27472 is classified under Surgery, in the Surgical Procedures on the Musculoskeletal System subgroup.
Repair Nonunion Or Malunion, Repair Nonunion Or Malunion Femur Distal To Head Andneck With Iliac Or Other Autogenous Bone Graft (Includes Obtaining Graft)
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 21Inpatient Hospital 22On Campus Outpatient Hospital |
| Common Modifiers | LTLeft side of body RTRight side of body |
| Hospital Outpatient Group (APC) | APC 5114 - Level 4 Musculoskeletal Procedures |
| Surgery Center Payment (ASC) | J8 - Device-intensive procedure, paid at an adjusted rate |
| Add-on Codes | 20703 |
| Common Revenue Codes | 03600637Sign up to view all 3 |
| Medicare Fee Schedule | $1,156.01 national non-facility rate (2026)View Medicare rates for 27472 |
| Medicaid Fee Schedule | $918.005 median of the 8 states in the free previewView Medicaid rates for 27472 |
National average reimbursement for CPT 27472 by major payers:
$1,655.42
BCBS / Anthem
$1,719.26
UnitedHealthcare
$1,805.19
Aetna
$2,073.20
Cigna
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 27472.
CPT 27472
5 of 25 sample ratesHigher to lower in this preview
Santa Barbara Surgery Center Lp
$7,888.00Published rateVip Surg Asc, LLC, Vip Surgical Center
Vip Surg Asc LLC
$4,250.00Published rateCentennial Surgunit, LLC, Centennial Surgery Center
Centennial Surgunit LLC
$2,885.00Published rateGastroenterology & Hepatology Consultants, PA, Wake Forest Endoscopy Center
Gastroenterology And Hepatology Consultants, P.A.
$1,757.00Published rateMelbourne Asc Lp, The Surgery Center Of Melbourne
Melbourne Asc Lp
$410.00Published rate
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See a sample payer proposalCPT 27472 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The table lists codes related to 27472. Select one to see its fee schedule.
| Code | Description |
|---|---|
| 27470-CPT | Rpair Nonunion Or Malunion Femur Distal To Head & Nck; W/O, Repair Nonunion Or Malunion Femur Distal To Head And Neck; Without |
| 27472-CPT | 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 | Arrest Epiphyseal Any Mthod (Eg Epiphysiodes); Distal Femur, Arrest Epiphyseal Any Method (Eg Epiphysiodesis); Distal Femur |
| 27503-CPT | 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 27472. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 27472 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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Frequently Asked Questions
What APC is CPT 27472 assigned to?
Medicare's hospital outpatient payment system (OPPS) assigns CPT 27472 to APC 5114 (Level 4 Musculoskeletal Procedures). An APC groups outpatient services that Medicare pays at the same base rate.
How does Medicare pay for CPT 27472 in an ambulatory surgery center?
CMS lists CPT 27472 with ASC payment indicator J8: Device-intensive procedure, paid at an adjusted rate.
Which add-on codes are billed with CPT 27472?
CMS add-on code edits list CPT 27472 as a primary code for these add-on codes: 20703.
Which revenue codes are billed with CPT 27472?
Hospital price transparency files list CPT 27472 under these revenue codes: 0360, 0637 and 0960. A revenue code names the hospital department or charge category for the line; it does not change what the service is.