CPT 27475 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-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 • 21 - Inpatient Hospital |
| Common Modifiers | • None • RT - Right side of body • LT - Left side of body |
| Complexity Level | Moderate |
National average reimbursement for CPT 27475 by major payers:
$883.70
$892.26
$940.33
$1,118.67
| 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 27475 | ||||||
United | 27475 | $2000.00 | 1396089108 - TRIANGLE ORTHOPAEDICS SURGERY CENTER | 275268935 - (NC) TRIANGLE ORTHOPAEDICS SURGERY CENTER | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27475 | $1400.00 | 1265816003 - CLEARVIEW SURGERY CENTER, LLC | 474123527 - (ID) CLEARVIEW SURGERY CENTER LLC | ID | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27475 | $3428.00 | 1154805646 - ANNE ARUNDEL-SCA SURGICENTER, LLC, AAMC SURGERY CENTER - ANNAPOLIS | 824763728 - (MD) ANNE ARUNDELSCA SURGICENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27475 | $1152.00 | 1093764045 - GASTROENTEROLOGY OF INDIANAPOLIS PC, DIGESTIVE HEALTH CENTER | 351641181 - (IN) GASTROENTEROLOGY OF INDIANAPOLIS, P . C. | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27475 | $3623.00 | 1427152073 - PATIENT PARTNERS LLC | 201400198 - (TN) PATIENT PARTNERS LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27475 | $3576.00 | 1952405284 - CHILDRENS HEALTH CARE SERVICES INC, CHILDRENS MINNETONKA | 411756478 - (MN) CHILDRENS HEALTH CARE SERVICES INC | MN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27475 | $2640.00 | 1295403426 - DRS LLC, MCMINNVILLE SURGERY CENTER | 320613056 - (OR) DRS LLC | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27475 | $489.00 | 1609039056 - FARSHID PAYDAR MD PC, THE EYE CLINIC | 454779006 - (AZ) FARSHID PAYDAR MD PC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27475 | $4203.00 | 1952516684 - POTTSTOWN HOSPITAL COMPANY LLC, POTTSTOWN MEMEORIAL MEDICAL CENTER | 822132538 | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27475 | $3570.00 | 1952333882 - THE MARYLAND CENTER FOR DIGESTIVE HEALTH LLC | 470856276 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27475 | $2643.00 | 1528027026 - VIRGINIA BEACH AMBULATORY SURGERY CENTER | 541448218 - (VA) VIRGINIA BEACH AMBULATORY SURGERY CENTER | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27475 | $3347.00 | 1134262868 - NORTH SHORE SAME DAY SURGERY LLC, NORTH SHORE SURGICAL CENTER | 364120432 - (IL) NORTH SHORE SAME DAY SURGERY LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27475 | $3623.00 | 1780610220 - PROLIANCE SURGEONS INC PS, PROLIANCE HILLSIDE MEDICAL SURGERY CENTER | 911606533 - (WA) PROLIANCE SURGEONS, INC., P.S. | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27475 | $640.00 | 1598189342 - MEI SURGERY CENTER LLC, MICHIGAN EYE SURGERY CENTER | 461591012 - (MI) MEI SURGERY CENTER LLC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27475 | $2393.00 | 1578142352 - CHELMSFORD SURGERY CENTER LLC | 854172372 - (MA) CHELMSFORD SURGERY CENTER LLC | MA | 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 |
Want to see your competitors' rates?
Start your trial today to unlock complete access to provider rates and fee schedules in your area.
Here's what you can do with PayerPrice
Renegotiate your managed care contracts
Benchmark your current rates against market averages to identify opportunities for rate optimization.
Prospect for new business using fee schedules
Access every provider's negotiated rates for every billing code in your market to inform your prospecting strategies.
Integrate real-time payer data into your workflows
Automatically keep fee schedules up-to-date without adding yet another log-in to your insurance systems. Connect via API or SQL.
PayerPrice shows you the exact negotiated rates that insurers publish under federal transparency rules.
We display the raw data directly from insurers' files, giving you the same information they make public. Learn more about Price Transparency.
CPT 27475 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 27475 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 27475 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 |
|---|---|---|
| 27472-CPT | High | Repair, Nonunion Or Malunion, Femur, Distal To Head And Neck; With Iliac Or Other Autogenous Bone Graft (Includes Obtaining Graft) |
| 27475-CPT | Moderate | Epiphysl Arrest-Stapl/Epiphy;D.Femr |
| 27477-CPT | Moderate | Arrest Epiphyseal Tibia Fibula Prox |
| 27500-CPT | Moderate | Clo Tx Femoral Shaft Fx W/O Manip |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 27475. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 27475 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.
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 27475) and we'll show you how you compare in 15 minutes or less.