CPT 27784 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 | • 21 - Inpatient Hospital • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • LT - Left side of body • RT - Right side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 27784 |
National average reimbursement for CPT 27784 by major payers:
$962.71
$937.50
$978.25
$1,182.13
| 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 27784 | ||||||
United | 27784 | $5963.00 | 1336131143 - PHOENIX ORTHOPAEDIC AMBULATORY CENTER, LLC, GATEWAY SURGERY CENTER | 860970374 - (AZ) PHOENIX ORTHOPAEDIC AMBULATORY CENTER, LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27784 | $2680.00 | 1073155834 - REGENCY AMBULATORY SURGERY CENTER ONE, LLC | 843154819 | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27784 | $4075.00 | 1467101907 - PEACE RIVER SURGERY CENTER | 853047089 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27784 | $2650.00 | 1508360181 - NEPHROLOGY VASCULAR LAB OF CENTRAL ALABAMA ASC LLC | 815281505 - (AL) NEPHROLOGY VASCULAR LAB OF CENTRAL ALABAMA ASC LLC | AL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27784 | $4535.00 | 1104233014 - TAMPA MINIMALLY INVASIVE SPINE SURGERY CENTER, LLC | 471211888 - (FL) TAMPA MINIMALLY INVASIVE SPINE SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27784 | $1795.00 | 1821397654 - RENUE SURGERY CENTER OF WAYCROSS, LLC | 273847480 - (GA) RENUE SURGERY CENTER OF WAYCROSS LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27784 | $4189.00 | 1720752629 - BAY SURGERY CENTERS | 453365193 - (MD) BAY SURGERY CENTERS | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27784 | $6492.00 | 1992796742 - SAN ANTONIO ENDOSCOPY, LP, SAN ANTONIO ENDOSCOPY CENTER | 202511329 - (TX) SAN ANTONIO ENDOSCOPY LP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27784 | $779.51 | 1548787203 - DEACONESS HOSPITAL, INC., <UNAVAIL> | 350593390 - DEACONESS HOSPITAL INC | IN | Radiology Clinic/Center (261QR0200X) |
United | 27784 | $4217.00 | 1184106049 - SURGCENTER OF NORTHERN BALTIMORE, LLC | 823078615 - (MD) SURGCENTER OF NORTHERN BALTIMORE LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27784 | $4866.00 | 1366536880 - SOUTHWEST WASHINGTON REGIONAL SURGERY CENTER, LLC | 911959910 - (WA) SOUTHWEST WASHINGTON REGIONAL SURGERY CENTER | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27784 | $2584.00 | 1871568329 - ROCKVILLE MD ENDOSCOPY ASC LLC, GASTROINTESTINAL ENDOSCOPY ASSOCIATES (GIEA) | 201732114 - (MD) ROCKVILLE MD ENDOSCOPY ASC LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27784 | $2750.00 | 1386650778 - NORTH BEND MEDICAL CENTER INC, NBMC-DAY SURGERY | 371843700 | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27784 | $5636.00 | 1962505354 - PROVIDENCE HEALTH SERVICES OF WACO, PROVIDENCE HEALTH CENTER | 741109636 - (TX) ASCENSION PROVIDENCE | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27784 | $3199.00 | 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 | 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 27784 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 27784 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 27784 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 |
|---|---|---|
| 27784-CPT | Moderate | Red Fx Open-Fibula |
| 27788-CPT | Moderate | Red Fx-Lateral Malleolus |
| 27792-CPT | Moderate | Red Fx Open-Lat Malleolus W Fixat |
| 27826-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 Fibula Only |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 27784. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 27784 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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