CPT 27566 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 | • 22 - On Campus Outpatient Hospital • 24 - Ambulatory Surgical Center |
| Common Modifiers | • None • LT - Left side of body • RT - Right side of body |
| Complexity Level | High |
National average reimbursement for CPT 27566 by major payers:
$1,212.94
$1,208.60
$1,220.43
$1,497.93
| 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 27566 | ||||||
United | 27566 | $6492.00 | 1346237328 - VICTORIA AMBULATORY SURGERY CENTER, LP, THE SURGERY CENTER | 352240144 - (TX) VICTORIA AMBULATORY SURGERY CENTER LP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27566 | $4185.00 | 1306375837 - CENTRAL COAST CARDIOVASCULAR ASC LLC | 821736669 - (CA) CENTRAL COAST CARDIOVASCULAR ASC LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27566 | $5000.00 | 1750844049 - FORT WORTH SURGICAL CENTER LP | 832752727 - (TX) FORT WORTH SURGICAL CENTER LP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27566 | $5012.00 | 1295381572 - SOUTH SUBURBAN SURGICAL SUITES, LLC, SOUTH SUBURBAN SURGICAL SUITES | 842207819 - (IN) SOUTH SUBURBAN SURGICAL SUITES LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27566 | $2807.00 | 1689216152 - BAPTIST HEALTH SURGERY CENTER LLC | 843280181 - (KY) BAPTIST HEALTH SURGERY CENTER, L | KY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27566 | $8090.00 | 1023359627 - THE EMORY CLINIC INC., EMORY AESTHETIC CENTER | 582030692 - EMORY UNIVERSITY | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27566 | $3247.00 | 1811957251 - AMBULATORY SURGERY CENTER OF CENTRALIA, LLC, SURGERY CENTER OF CENTRALIA | 883961418 | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27566 | $2788.00 | 1194970418 - PACIFIC CATARACT AND LASER INSTITUTE INC PC | 911394965 - PACIFIC CATARACT AND LASER INSTITUTE, INC., PC | NM | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27566 | $9182.00 | 1083644124 - MEMORIAL HERMANN SURGERY CENTER SOUTHWEST LLP, MEMORIAL HERMANN SURGERY CENTER SOUTHWEST | 202866884 - (TX) MEMORIAL HERMANN SURGERY CENTER SOUTHWEST LLP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27566 | $4641.00 | 1891745956 - NORTH SUBURBAN SPINE CENTER LP, NORTH METRO SURGERY CENTER | 571231282 | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27566 | $1497.00 | 1114980166 - NEW PORT RICHEY SURGERY CENTER LTD | 592907068 - (FL) NEW PORT RICHEY SURGERY CENTER LTD | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27566 | $4535.00 | 1598927147 - MORTON PLANT MEASE HEALTH SERVICES INC, BARDMOOR OUTPATIENT CENTER | 204385452 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27566 | $905.00 | 1700856242 - SOUTHERN OHIO EYE SURGERY CENTER, LLC | 43700734 - (OH) SOUTHERN OHIO EYE SURGERY CENTER LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27566 | $1987.00 | 1093736795 - HATTIESBURG CLINIC PA, AMBULATORY SURGERY CENTER | 640507572 - HATTIESBURG CLINIC, P.A. | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27566 | $2795.00 | 1083384432 - NASHVILLE SURGICENTER, LLC | 474086590 - (TN) NASHVILLE SURGICENTER LLC | TN | 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 27566 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 27566 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 27566 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 |
|---|---|---|
| 27556-CPT | High | Open Treatment Of Knee Dislocation, Includes Internal Fixation, When Performed; Without Primary Ligamentous Repair Or Augmentation/Reconstruction |
| 27558-CPT | High | Open Treatment Of Knee Dislocation, Includes Internal Fixation, When Performed; With Primary Ligamentous Repair, With Augmentation/Reconstruction |
| 27560-CPT | Moderate | Clo Tx Patellar Disloc W/O Anes |
| 27566-CPT | High | Red Disloc Open-Patella |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 27566. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 27566 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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