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See a sample rate comparisonHealthcare 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 | 21 - Inpatient Hospital 23 - Emergency Room |
| Common Modifiers | None RT - Right side of body LT - Left side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 27781 |
| Medicaid Fee Schedule | View Medicaid rates for 27781 |
National average reimbursement for CPT 27781 by major payers:

$602.62

$569.46

$613.30

$733.46
Choose a payer to see a sample of rates for CPT 27781.
Memorial Hermann Surgery Center Northwest LLP
Physicians' Surgicenter, LLC
Legent Outpatient Surgery Euless LLC
Digestive Health Specialists, P.A.
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Rate Benchmarking
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See a sample rate comparisonPayer Contract Negotiation
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See a sample payer proposalCPT 27781 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 27781 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 27781 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 | Closed Treatment Of Proximal F, Closed Treatment Of Proximal Fibula Or Shaft Fracturewithout Manipulation Closed Treatment Of Proximal Fibula Or Shaft Fracture |
| 27781-CPT | Moderate | Closed Treatment Of Proximal F, Closed Treatment Of Proximal Fibula Or Shaft Fracture With Manipulation Closed Treatment Of Proximal Fibula Or Shaft Fracture With |
| 27784-CPT | Moderate | Surgical Repair Of Broken Leg, Surgery To Repair A Broken Leg Bone (Fibula). Pins Wires Or Screws May Be Used To Hold The Bone Together. |
| 27786-CPT | Moderate | Treatment Of A Broken Ankle, Treatment Of A Broken Ankle (Lateral Malleolus On Outer Side Of Ankle). A Cast Or Brace Is Applied. The Bone May Be Manually Moved Into Proper Alignment. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 27781. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 27781 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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