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 | • Surgery • Surgical Procedures on the Musculoskeletal System |
| 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 |
National average reimbursement for CPT 27759 by major payers:
$1,328.98
$1,355.68
$1,436.46
$1,682.74
| 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 27759 | ||||||
United | 27759 | $3514.00 | 1164007068 - SW HEALTH LP | 853293126 - (TX) SW HEALTH LP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27759 | $5000.00 | 1952776098 - BAYTOWN ASC, LP, BAYTOWN HEART & VASCULAR SURGERY CENTER | 474501044 - (TX) BAYTOWN ASC LP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27759 | $2202.00 | 1871538694 - SOUTHWEST ENDOSCOPY LTD | 850452091 - (NM) SOUTHWEST ENDOSCOPY LTD | NM | 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 | 1336138650 - WILLIAM ROBERTS | 350593390 - DEACONESS HOSPITAL INC | IN | Anesthesiology Physician (207L00000X) |
United | 27759 | $3800.00 | 1881620466 - MIDLANDS ORTHOPAEDICS SURGERY CENTER, LLC | 203345412 - (SC) MIDLANDS ORTHOPAEDICS SURGERY CENTER LLC | SC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27759 | $4100.00 | 1760064885 - PHOENIX HEART AMBULATORY SURGERY AND ELECTROPHYSIOLOGY, LLC, PHASE SURGERY CENTER | 852246569 - (AZ) PHOENIX HEART AMBULATORY SURGERY AND ELECTROPHYSIOLOGY LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27759 | $15533.00 | 1104996768 - GREATER DAYTON SURGERY CENTER LLC | 202913367 - (OH) GREATER DAYTON SURGERY CENTER | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
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 | $1588.00 | 1316900830 - BAYONET POINT SURGERY CENTER LTD | 200670560 - (FL) BAYONET POINT SURGERY CENTER LTD | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27759 | $1795.00 | 1639365240 - SAVANNAH PAIN CENTER, LLC | 203978153 - (GA) SAVANNAH PAIN CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27759 | $3060.00 | 1851678981 - RIDGECREST SPECIALTY SURGERY CENTER, A PROFESSIONAL CORPORATION | 453602999 - (CA) RIDGECREST SPECIALTY SURGERY CENTER A PROFESSIONAL CORPORATION | CA | 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 | $7229.00 | 1962405803 - MID RIVERS AMBULATORY SURGERY CENTER LP, MID RIVERS SURGERY CENTER | 203833902 - (MO) MID RIVERS AMBULATORY SURGERY CENTER LP | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27759 | $8818.00 | 1720020472 - DENTON SURGERY CENTER LLC, TEXAS HEALTH SURGERY CENTER DENTON | 470926556 - (TX) DENTON SURGERY CENTER, LLC DBA TEXAS HEALTH SURGERY CENTER DENTON | 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 27759 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 27759 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 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 | Treat Fx-Tibial Shaft |
| 27752-CPT | Moderate | Closed Treatment Of Tibial Shaft Fracture (With Or Without Fibular Fracture); With Manipulation, With Or Without Skeletal Traction |
| 27756-CPT | Moderate | Red Fx Open-Tibial Shaft Simple |
| 27759-CPT | High | Treatment Of Tibial Shaft Fracture (With Or Without Fibular Fracture) By Intramedullary Implant With Or Without Interlocking Screws And/Or Cerclage (Desc Rev 1/1/03) |
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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