CPT 27759 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 | Fracture and/or Dislocation Procedures on the Leg (Tibia and Fibula) and Ankle Joint Surgical Procedures on the Leg (Tibia and Fibula) and Ankle Joint |
| Common Place of Service | 21 - Inpatient Hospital 22 - On Campus Outpatient Hospital |
| Common Modifiers | None RT - Right side of body LT - Left side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 27759 |
National average reimbursement for CPT 27759 by major payers:
$1,328.98
$1,355.68
$1,436.46
$1,636.70
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
United | 27759 | $3229.00 | 1386858595 - ALDERWOOD SURGERY CENTER LLC | 204979154 - (WA) ALDERWOOD SURGICAL CENTER | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27759 | $2492.00 | 1841298437 - WEST PALM OUTPATIENT SURGERY AND LASER CENTER LTD, NORTHPOINT SURGERY & LASER CENTER | 650592518 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27759 | $3474.00 | 1306134838 - ASC DEVELOPMENT COMPANY LLC | 203405773 - (MD) ASC DEVELOPMENT COMPANY LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27759 | $4500.00 | 1386213460 - GEORGIA INTERVENTIONAL PAIN | 854240994 - (GA) GEORGIA INTERVENTIONAL PAIN | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27759 | $6588.00 | 1891148219 - SUMMIT AMBULATORY SURGICAL CENTER, LLC | 522148280 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27759 | $3339.00 | 1730374307 - NORTHVIEW ORTHOPAEDIC SURGERY CENTER, P.C. | 261245423 - (GA) NORTHVIEW ORTHOPAEDIC SURGERY CENTER PC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27759 | $1739.84 | 1306009253 - JOSHUA KINDRAT | 350593390 - DEACONESS HOSPITAL INC | IN | Emergency Medicine Physician (207P00000X) |
United | 27759 | $8087.00 | 1760412803 - MEMORIAL HERMANN SURGERY CENTER KATY LLP | 203360737 - (TX) MEMORIAL HERMANN SURGERY CENTER KATY LLP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27759 | $4842.00 | 1770112617 - UCHEALTH AMBULATORY SURGERY CENTERS, UCHEALTH CHERRY CREEK NORTH SURGERY CENTER | 383984888 - (CO) UCHEALTH AMBULATORY SURGERY CENTERS | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27759 | $2480.00 | 1467920389 - KU MEDWEST AMBULATORY SURGERY CENTER, LLC | 20664568 - (KS) KU MEDWEST AMBULATORY SURGERY CENTER LLC | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27759 | $3871.00 | 1174258107 - FW SPECIALTY SURGICARE, LLC | 854261198 - (TX) FW SPECIALTY SURGICARE LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27759 | $2744.00 | 1477503175 - PALMS WEST SURGERY CENTER LTD | 201008459 - (FL) PALMS WEST SURGERY CENTER LTD | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27759 | $1800.00 | 1558328518 - BUTLER AMBULATORY SURGERY CENTER L L C | 61728190 - (PA) BUTLER AMBULATORY SURGERY CENTER, LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27759 | $2932.00 | 1578142352 - CHELMSFORD SURGERY CENTER LLC | 854172372 - (MA) CHELMSFORD SURGERY CENTER LLC | MA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27759 | $2974.00 | 1467153718 - WATERFRONT SURGERY CENTER LLC | 881302078 - (KS) WATERFRONT SURGERY CENTER LLC | KS | 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 27759 vs. Other Surgical Procedures on the Leg (Tibia and Fibula) and Ankle Joint Codes
The CPT 27759 code is part of the Fracture and/or Dislocation Procedures on the Leg (Tibia and Fibula) and Ankle Joint services used for Surgical Procedures on the Leg (Tibia and Fibula) and Ankle Joint. 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 27759 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 |
|---|---|---|
| 27750-CPT | Moderate | Closed Treatment Of Tibial Sha, Closed Treatment Of Tibial Shaft Fracture (With Orwithoutfibular Fracture) Without Manipulation C Losed Treatment Of Tibial Shaft Fracture (With Or Without |
| 27752-CPT | Moderate | Treatment Of Tibia Fracture, Closed Treatment Of Tibial Shaft Fracture With Or Without Fibular Fracture With Manipulation With Or Without Skeletal Traction |
| 27756-CPT | Moderate | Percutaneous Skeletal Fixation, Percutaneous Skeletal Fixation Of Tibial Shaft Fracture(With Or Without Fibular Fracture) (Eg Pins Or Screws) Percutaneous Skeletal Fixation Of Tibial Shaft Fracture |
| 27759-CPT | High | Open Treatment Of Tibial Shaft, Open Treatment Of Tibial Shaft Fracture (With Or Withoutfibular Fracture) By Intramedullary Implantwith Or Without Interlocking Screws Andor Cercl Age |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 27759. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 27759 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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