CPT 27503 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 • 23 - Emergency Room |
| Common Modifiers | • None • LT - Left side of body • RT - Right side of body |
| Complexity Level | High |
National average reimbursement for CPT 27503 by major payers:
$1,076.47
$1,081.41
$1,107.13
$1,342.92
| 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 27503 | ||||||
United | 27503 | $574.00 | 1194724690 - ENDOSCOPY CENTER OF DAYTON NORTH LLC | 311703317 - (OH) ENDOSCOPY CENTER OF DAYTON NORTH LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27503 | $150.00 | 1710924899 - DMG SURGICAL CENTER LLC, SURGICAL CENTER OF DUPAGE MEDICAL GROUP | 371474161 | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27503 | $179.00 | 1700263415 - NORTH POINT SURGERY CENTER, LLC | 464488421 - (MO) NORTH POINT SURGERY CENTER LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27503 | $79.00 | 1154555472 - GEORGIA RETINA SURGERY CENTER, LLC | 262303683 - (GA) GEORGIA RETINA SURGERY CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27503 | $157.00 | 1235104738 - THE OVERLAND PARK KS ENDOSCOPY ASC LLC, ENDOSCOPIC IMAGING CENTER | 201635603 - (KS) THE OVERLAND PARK KS ENDOSCOPY ASC LLC | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27503 | $423.00 | 1750517561 - CANON CITY CO MULTI SPECIALTY ASC LLC, ARKANSAS VALLEY SURGERY CENTER | 264730485 - (CO) CANON CITY CO MULTI SPECIALTY ASC LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27503 | $566.00 | 1992713176 - DESERT RIDGE OUTPATIENT SURGERY LLC | 202528902 - (AZ) DESERT RIDGE OUTPATIENT SURGERY LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27503 | $4503.79 | 1619096161 - THE WESTERN PENNSYLVANIA HOSPITAL, FORBES REGIONAL CAMPUS | 250969492 - (PA) HIGHMARK HEALTH | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27503 | $1857.00 | 1114034006 - SURGICAL CENTER AT MILLBURN, LLC | 571166137 - (NJ) SURGICAL CENTER AT MILLBURN LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27503 | $207.00 | 1396919783 - SURGCENTER OF SOUTHERN MARYLAND, LLC | 261572885 - (MD) SURGCENTER OF SOUTHERN MARYLAND | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27503 | $103.00 | 1730374307 - NORTHVIEW ORTHOPAEDIC SURGERY CENTER, P.C. | 261245423 - (GA) NORTHVIEW ORTHOPAEDIC SURGERY CENTER PC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27503 | $441.00 | 1992700090 - TAMPA BAY SPECIALTY SURGERY CENTER LLC, TAMPA BAY SPECIALTY SURGERY CENTER | 331019420 - (FL) TAMPA BAY SPECIALTY SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27503 | $315.00 | 1922141647 - RIVER NORTH SAME DAY SURGERY LLC, NORTHWESTERN MEDICINE SURGERY CENTER RIVER NORTH | 364091497 | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27503 | $64.00 | 1508210378 - APEX MEDICAL SURGERY CENTER, LLC | 471906463 - (GA) APEX MEDICAL SURGERY CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27503 | $63.00 | 1104272780 - ENT OF SOUTH GEORGIA SURGERY CENTER LLC | 474050916 - (GA) ENT OF SOUTH GEORGIA SURGERY CENTER LLC | GA | 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 27503 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 27503 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 27503 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 |
|---|---|---|
| 27500-CPT | Moderate | Clo Tx Femoral Shaft Fx W/O Manip |
| 27501-CPT | Moderate | Closed Treatment Of Supracondylar Or Transcondylar Femoral Fracture With Or Without Intercondylar Extension, Without Manipulation |
| 27503-CPT | High | Closed Treatment Of Supracondylar Or Transcondylar Femoral Fracture With Or Without Intercondylar Extension, With Manipulation, With Or Without Skin Or Skeletal Traction |
| 27506-CPT | High | Open Treatment Of Femoral Shaft Fracture, With Or Without External Fixation, With Insertion Of Intramedullary Implant, With Or Without Cerclage And/Or Locking Screws |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 27503. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 27503 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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