CPT 27780 Fee Schedule
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.
| 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 • RT - Right side of body • LT - Left side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 27780 |
National average reimbursement for CPT 27780 by major payers:
$417.41
$402.43
$431.78
$521.31
| 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 27780 | ||||||
United | 27780 | $531.66 | 1043451727 - BHARGAV TRIVEDI | 350593390 - DEACONESS HOSPITAL INC | IN | Neurology Physician (2084N0400X) |
United | 27780 | $863.00 | 1629664156 - OSU WEXNER MEDICAL CENTER AMBULATORY SURGERY CENTER, OSU WEXNER MEDICAL CENTER AMBULATORY SURGERY CENTER NEW ALBANY | 854149946 - (OH) OSU WEXNER MEDICAL CENTER AMBULATORY SURGERY CENTER | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27780 | $45.00 | 1093907339 - TAYLOR SURGERY CENTER, LLC, SURGICAL ARTS SURGERY CENTER | 710860395 - (AR) TAYLOR SURGERY CENTER LLC | AR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27780 | $566.00 | 1598767154 - NORTHWEST GEORGIA ORTHOPAEDIC SURGERY CENTER, LLC | 582132641 - (GA) NORTHWEST GEORGIA ORTHOPAEDIC SURGERY CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27780 | $150.00 | 1700282852 - LAKE JACKSON ENDOSCOPY CENTER, LP. | 800513571 - (TX) LAKE JACKSON ENDOSCOPY CENTER LP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27780 | $150.00 | 1245722883 - WOMENS HEALTH CENTER, HAMID ZADEH MD INC | 473398040 - (CA) WOMENS HEALTH CENTER | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27780 | $525.00 | 1346322187 - XRS LLC, COLUMBUS PAIN INSTITUTE | 201384877 - (IN) XRS LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27780 | $531.00 | 1841395894 - FRANKLIN ENDOSCOPY CENTER, LLC, FRANKLIN ENDOSCOPY CENTER | 383730672 - (TN) FRANKLIN ENDOSCOPY CENTER LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27780 | $511.00 | 1902070832 - GASTRO OPERATING COMPANY LLC, (DBA) MEADOWBROOK ENDOSCOPY CENTER | 202432134 - (NY) GASTRO OPERATING COMPANY, LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27780 | $244.27 | 1972030351 - JAMIE MARKSBERRY | 350593390 - DEACONESS HOSPITAL INC | IN | Nurse Practitioner (363L00000X) |
United | 27780 | $97.00 | 1740424944 - GASTRO CARE, LLC | 263402953 - (OH) GASTRO CARE LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27780 | $520.00 | 1427005313 - WESTERN WASHINGTON MEDICAL GROUP, INC PS, WESTERN WASHINGTON MEDICAL GROUP ENDOSCOPY CENTER | 911602128 - (WA) WESTERN WASHINGTON MEDICAL GROUP, INC., P.S. | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27780 | $150.00 | 1295204113 - HUNTINGTON SPECIALTY SURGERY LLC | 831389054 - (CA) HUNTINGTON SPECIALTY SURGERY LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27780 | $400.00 | 1861931263 - METHODIST CRAIG RANCH SURGERY CENTER LLC | 352583971 - (TX) METHODIST CRAIG RANCH SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27780 | $703.00 | 1811973639 - SUMMIT ORTHOPEDICS LTD, DBA LANDMARK SURGERY CENTER | 411762331 - SUMMIT ORTHOPEDICS, LTD. | MN | 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 27780 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 27780 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 27780 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 |
|---|---|---|
| 27780-CPT | Moderate | Clo Tx Prox Fib/Shaft Fx W/O Manip |
| 27781-CPT | Moderate | Tx Closed Proximal Fibulaor Shaft Fx;W |
| 27786-CPT | Moderate | Clo Tx Dist Fib Fx W/O Manip |
| 27828-CPT | High | Open Treatment Of Fracture Of Weight Bearing Articular Surface/Portion Of Distal Tibia (Eg, Pilon Or Tibial Plafond), With Internal Fixation, When Performed; Of Both Tibia And Fibula |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 27780. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 27780 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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