CPT 27818 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 | • 23 - Emergency Room • 21 - Inpatient Hospital |
| Common Modifiers | • None • 54 - Surgical Care Only • RT - Right side of body |
| Complexity Level | Moderate |
National average reimbursement for CPT 27818 by major payers:
$660.90
$651.78
$697.07
$826.38
| 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 27818 | ||||||
United | 27818 | $348.00 | 1518070879 - EHLERS EYE SURGERY LLC | 270079770 - (WA) EHLERS EYE SURGERY LLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27818 | $390.00 | 1538579313 - EYE SURGERY CENTER OF NORTH DALLAS | 462356251 - (TX) EYE SURGERY CENTER OF NORTH DALLAS | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27818 | $400.00 | 1811125149 - KNOXVILLE ORTHOPAEDIC SURGERY CENTER LLC | 262437385 - (TN) KNOXVILLE ORTHOPAEDIC SURGERY CENTER LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27818 | $344.00 | 1093895757 - PATRICK D REEVES MDPA, WILSON SURGICENTER | 412062384 - (TX) PATRICK D. REEVES, M.D., P.A. | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27818 | $318.00 | 1104214261 - WEST CENTRAL SURGICAL CENTER-BAYSIDE | 472619181 - (OH) WEST CENTRAL SURGICAL CENTERBAYSIDE | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27818 | $2350.00 | 1952331092 - MEMORIAL HERMANN SURGERY CENTER SUGAR LAND LLP | 203233617 - (TX) MEMORIAL HERMANN SURGERY CENTER SUGAR LAND LLP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27818 | $934.00 | 1942472931 - SURGCENTER OF GLEN BURNIE, SURGCENTER OF GLEN BURNIE, LLC | 261572774 - (MD) SURGCENTER OF GLEN BURNIE, LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27818 | $1783.00 | 1649827973 - PARK NICOLLET METHODIST HOSPITAL, PARK NICOLLET SAME DAY SURGERY CENTER | 410132080 - (MN) PARK NICOLLET HEALTH SERVICES | MN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27818 | $545.00 | 1932145109 - VALLEY DIGESTIVE CENTER INC, VALLEY DIGESTIVE HEALTH CENTER | 204484163 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27818 | $953.00 | 1629386784 - ODESSA ENDOSCOPY CENTER LLC | 273305505 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27818 | $848.00 | 1174999700 - ADVANCED SURGERY CENTER OF CENTRAL IOWA, LLC | 472673565 - (IA) ADVANCED SURGERY CENTER OF CENTRAL IOWA LLC | IA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27818 | $967.00 | 1437419660 - ADVANCED SURGERY CENTER OF METAIRIE LLC | 453386956 - (LA) ADVANCED SURGERY CENTER OF METAIRIE | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27818 | $2026.00 | 1295748531 - THE EMORY CLINIC INC, EMORY CLINIC AMBULATORY SURGERY CENTER | 582030692 - EMORY UNIVERSITY | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27818 | $480.00 | 1073757480 - ENDOSCOPY CENTER OF WESTERN COLORADO INC | 262645683 | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27818 | $848.82 | 1962498741 - RUPINDER SANDHU | 350593390 - DEACONESS HOSPITAL INC | VA | Hospitalist Physician (208M00000X) |
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 27818 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 27818 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 27818 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 |
|---|---|---|
| 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 |
| 27816-CPT | Moderate | Clo Tx Trimalleolar Ank Fx Wo Manip |
| 27818-CPT | Moderate | Tx Closed Trimalleolar Ankle Fx;W Manipu |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 27818. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 27818 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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