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See a sample rate comparisonCPT 27530 Fee Schedule
Last Verified: September 2026
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.
Closed Treatment Of Tibial Fra, Closed Treatment Of Tibial Fracture Proximal (Plateau)Without Manipulation Closed Treatment Of Tibial Fracture Proximal (Plateau)
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 11 - Office 23 - Emergency Room 21 - Inpatient Hospital |
| Common Modifiers | None LT - Left side of body RT - Right side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 27530 |
| Medicaid Fee Schedule | View Medicaid rates for 27530 |
National average reimbursement for CPT 27530 by major payers:
$458.44
$432.19
$470.68
$524.91
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CPT 27530
5 of 25 sample ratesHigher to lower in this preview
Prospect Ccmc, LLC
$1,957.00Published rateCapitol Surgical Center LLC
$566.00Published rateElmhurst Outpatient Surgery Center LLC
Elmhurst Outpatient Surgery Center, LLC
$255.00Published rateWest Michigan Surgery Center, LLC
Michigan Primary Care Partners PC
$179.00Published rateAllegany Ambulatory Surgery Center LLC
$52.00Published rate
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See a sample payer proposalCPT 27530 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 27530 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 27530 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 |
|---|---|---|
| 27524-CPT | High | Open Treatment Of Patellar Fra, Open Treatment Of Patellar Fracture With Internalfixation Andor Partial Or Complete Patellectomy And Soft Tissue Repair |
| 27530-CPT | Moderate | Closed Treatment Of Tibial Fra, Closed Treatment Of Tibial Fracture Proximal (Plateau)Without Manipulation Closed Treatment Of Tibial Fracture Proximal (Plateau) |
| 27532-CPT | Moderate | Closed Treatment Of Tibial Fra, Closed Treatment Of Tibial Fracture Proximal (Plateau)With Or Without Manipulation With Skeletal Traction Closed Treatment Of Tibial Fracture Proximal (Plateau) |
| 27535-CPT | High | Surgical Repair Of Broken Leg, Surgery To Repair A Broken Leg Bone (Tibia). Pins Plates Wires Or Screw May Be Used To Stabilize The Broken Bone. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 27530. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 27530 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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