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 |
| Medicare Fee Schedule | View Medicare rates for 27566 |
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 | $5000.00 | 1982975959 - ARCHIBALD SURGERY CENTER, LLC | 453730425 - (CA) ARCHIBALD SURGERY CENTER | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27566 | $6588.00 | 1467601625 - MNH GI SURGICAL CENTER LLC, MNH SURGICAL CENTER | 263094275 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27566 | $6492.00 | 1942472931 - SURGCENTER OF GLEN BURNIE, SURGCENTER OF GLEN BURNIE, LLC | 261572774 - (MD) SURGCENTER OF GLEN BURNIE, LLC | MD | 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 | $390.00 | 1982696894 - AFFILIATED AMBULATORY SURGERY CENTER LLC | 311719268 - (OH) AFFILIATED AMBULATORY SURGERY CENTER, LLC | OH | 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 | $4742.00 | 1609815075 - ORTHOATLANTA SURGERY CENTER OF FAYETTEVILLE, LLC | 202961633 - (GA) ORTHOATLANTA SURGERY CENTER OF FAYETTEVILLE LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27566 | $2075.00 | 1295772101 - CAPE CORAL AMBULATORY SURGERY CENTER, LLC, CAPE CORAL SURGERY CENTER | 202001489 - (FL) CAPE CORAL AMBULATORY SURGERY CENTER LLC | FL | 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 | $9182.00 | 1184922353 - PEARLAND SURGERY CENTER, LLC | 270289493 - (TX) PEARLAND SURGERY CENTER, LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27566 | $6365.00 | 1740778554 - ORO VALLEY SURGICAL SUITES LLC | 823931790 - (AZ) ORO VALLEY SURGICAL SUITES, LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27566 | $819.00 | 1134183056 - TOPEKA SURGERY CENTER | 364500418 | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27566 | $5963.00 | 1013539709 - BSC BILTMORE LLC | 850820003 - (AZ) BSC BILTMORE LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27566 | $6492.00 | 1104298009 - RED CEDAR SURGERY CENTER, LLC, RED CEDAR SURGERY CENTER, PLLC | 472947364 - (MI) RED CEDAR SURGERY CENTER, PLLC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27566 | $7888.00 | 1225375587 - GCSA AMBULATORY SURGERY CENTER, LLC, GASTROENTEROLOGY CONSULTANTS OF SAN ANTONIO - STONE OAK | 611699459 - (TX) GCSA AMBULATORY SURGERY CENTER LLC | TX | 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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