CPT 27509 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 | • 21 - Inpatient Hospital • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • LT - Left side of body • RT - Right side of body |
| Complexity Level | Moderate |
National average reimbursement for CPT 27509 by major payers:
$928.87
$880.53
$919.93
$1,121.86
| 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 27509 | ||||||
United | 27509 | $846.00 | 1255746087 - OSI, LLC | 352509822 - (MI) OSI, LLC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27509 | $2105.00 | 1053597161 - 1800 MCDONOUGH ROAD SURGERY CENTER LLC | 261278011 - (IL) 1800 MCDONOUGH ROAD SURGERY CENTER LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27509 | $1200.00 | 1306079330 - WHITEWATER SURGERY CENTER LLC, WHITEWATER SURGERY CENTER | 264540954 - (IN) WHITEWATER SURGERY CENTER LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27509 | $2924.00 | 1710315619 - RIDGELINE SURGICENTER, LLC | 463848829 | UT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27509 | $970.00 | 1588237523 - CARDIO-KIDNEY VASCULAR CARE LLC | 851989732 - (KS) CARDIO-KIDNEY VASCULAR CARE LLC | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27509 | $3930.00 | 1770566192 - SUMMERLIN BEND SURGERY CENTER LLP, ADULT & CHILDRENS SURGERY CENTER OF SOUTHWEST FLORIDA | 651005912 - (FL) SUMMERLIN BEND SURGERY CENTER | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27509 | $1612.50 | 1811220429 - SURGICARE OF MANHATTAN, LLC | 205679305 - (NY) SURGICARE OF MANHATTAN LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27509 | $1436.00 | 1992752794 - SIERRA EYE AMBULATORY SURGERY CENTER, LLC | 770509889 - (CA) SIERRA EYE AMBULATORY SURGERY CENTER LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27509 | $2307.00 | 1811515034 - SALMON SURGERY CENTER LLC | 844895716 - (WA) SALMON SURGERY CENTER LLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27509 | $1200.00 | 1831665983 - WAXAHACHIE SURGERY CENTER | 831268553 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27509 | $6651.00 | 1215307012 - BAY AREA SURGICENTER, LLC, BRANDON SURGERY CENTER | 474961128 - (FL) BAY AREA SURGICENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27509 | $1203.00 | 1437706140 - GEISINGER-HM JOINT VENTURE, LLC | 831871064 | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27509 | $1400.00 | 1396700944 - WATTS PLASTIC SURGERY ASSOCIATION, P.C. | 161661339 - (NJ) WATTS PLASTIC SURGERY ASSOCIATION PC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27509 | $3657.00 | 1275067068 - UNIVERSITY OF MINNESOTA HEALTH CLINICS AND SURGERY CENTER, INC, UMHCSC ASC EPISODIC BUNDLE | 465444821 - (MN) UNIVERSITY OF MINNESOTA HEALTH CLINICS AND SURGERY CENTER INC | MN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27509 | $3730.00 | 1902851009 - 90210 SURGERY MEDICAL CENTER, LLC, 90210 SURGERY MEDICAL CENTER AT LINDEN | 134341801 - (CA) 90210 SURGERY MEDICAL CENTER | CA | 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 27509 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 27509 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 27509 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 |
| 27509-CPT | Moderate | Percutaneous Skeletal Fixation Of Femoral Fracture, Distal End, Medial Or Lateral Condyle, Or Supracondylar Or Transcondylar, With Or Without Intercondylar Extension, Or Distal Femoral Epiphyseal Separation |
| 27511-CPT | High | Open Treatment Of Femoral Supracondylar Or Transcondylar Fracture Without Intercondylar Extension, Includes Internal Fixation, When Performed |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 27509. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 27509 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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