CPT 27814 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 | • 22 - On Campus Outpatient Hospital • 21 - Inpatient Hospital |
| Common Modifiers | • None • RT - Right side of body • LT - Left side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 27814 |
National average reimbursement for CPT 27814 by major payers:
$1,079.37
$1,046.04
$1,105.38
$1,300.60
| 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 27814 | ||||||
United | 27814 | $1957.00 | 1801822739 - SYLVAN SURGERY CENTER, INC. | 200500901 - (CA) SYLVAN SURGERY CENTER INC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27814 | $6087.00 | 1720530405 - GRAND RAPIDS SURGICAL SUITES LLC | 811321919 - (MI) GRAND RAPIDS SURGICAL SUITES, PLLC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27814 | $2500.00 | 1780014068 - PEAK SURGERY CENTER LLC | 463392531 - (CO) PEAK SURGERY CENTER LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27814 | $1913.00 | 1447599659 - SOUTHEAST EYE SURGERY CENTER, LLC | 455054338 - (TN) SOUTHEAST EYE SURGERY CENTER LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27814 | $3700.00 | 1861931263 - METHODIST CRAIG RANCH SURGERY CENTER LLC | 352583971 - (TX) METHODIST CRAIG RANCH SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27814 | $1742.00 | 1740448711 - TREVOSE SPECIALTY CARE SURGICAL CENTER, LLC | 262420083 - (PA) TREVOSE SPECIALTY CARE SURGICAL CENTER, LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27814 | $6945.00 | 1336204668 - PHYSICIANS SURGICENTER LLC | 223550463 - (NJ) PHYSICIANS' SURGICENTER, LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27814 | $2463.00 | 1588427991 - LAKELAND REGIONAL HEALTH SURGERY CENTER, LLC | 934616298 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27814 | $8201.00 | 1497120588 - SUMMIT ORTHOPEDICS, LTD, PLYMOUTH SURGERY CENTER | 411762331 - SUMMIT ORTHOPEDICS, LTD. | MN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27814 | $683.00 | 1609968478 - IOWA ENDOSCOPY CENTER, INC. | 421407285 - (IA) IOWA ENDOSCOPY CENTER INC | IA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27814 | $5330.00 | 1962568543 - ENDOSCOPY CENTER OF OCEAN COUNTY, LLC | 223461117 - (NJ) ENDOSCOPY CENTER OF OCEAN COUNTY, PC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27814 | $5484.00 | 1205809795 - OAKHURST ENDOSCOPY ASC LLC, OCEAN SURGICAL PAVILION, INC. | 223182653 | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27814 | $4500.00 | 1871550392 - CONNECTICUT SURGERY CENTER LIMITED PARTNERSHIP | 61592173 - (CT) CONNECTICUT SURGERY CENTER LIMITED PARTNERSHIP | CT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27814 | $4818.00 | 1871838003 - NORTHWEST REGIONAL SURGERY CENTER, LLC | 460823847 - (IN) NORTHWEST REGIONAL SURGERY CENTER LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27814 | $860.00 | 1407801509 - ATLANTIC SURGERY CENTER,LLC | 223625894 - (NJ) ATLANTIC SURGERY CENTERLLC | NJ | 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 27814 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 27814 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 27814 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 |
|---|---|---|
| 27766-CPT | Moderate | Red Fx Open-Med Malleolus W Fixat |
| 27768-CPT | Moderate | Cltx Post Ankle Fx W/Mnpj |
| 27810-CPT | Moderate | Closed Treatment Of Bimalleolar Ankle Fracture (Eg, Lateral And Medial Malleoli, Or Lateral And Posterior Malleoli Or Medial And Posterior Malleoli); With Manipulation |
| 27814-CPT | High | Open Treatment Of Bimalleolar Ankle Fracture (Eg.Lateral And Medial Malleoli Or Lateral And Posterior Malleoli Or Medial And Posterior Malleoli) Includes Internal Fixation When Performed |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 27814. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 27814 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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