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 |
| Medicare Fee Schedule | View Medicare rates for 27818 |
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 | $1963.00 | 1881124550 - TEXAS HEALTH SPINE SURGERY CENTER ALLEN, LLC | 300957868 - (TX) TEXAS HEALTH SPINE SURGERY CENTER ALLEN LLC | TX | 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 | $356.00 | 1518592021 - FIRST SURGERY CENTER, INC. | 842066148 - (CA) FIRST SURGERY CENTER INC | CA | 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 | $2026.00 | 1295748531 - THE EMORY CLINIC INC, EMORY CLINIC AMBULATORY SURGERY CENTER | 582030692 - EMORY UNIVERSITY | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27818 | $1019.00 | 1679985857 - FOUNTAIN VALLEY SURGERY CENTER, LLC | 371756991 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27818 | $170.00 | 1134499684 - CHILDRENS SURGERY CENTER OF MALVERN, LLC | 452608984 - (PA) CHILDRENS SURGERY CENTER OF MALVERN LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27818 | $689.00 | 1801825880 - SURGERY CENTER AT RIVER ROAD, LLC, AESTHETIC SURGERY AT HACIENDA DEL SOL | 760824670 - (AZ) SURGERY CENTER AT RIVER ROAD, LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27818 | $563.00 | 1528027026 - VIRGINIA BEACH AMBULATORY SURGERY CENTER | 541448218 - (VA) VIRGINIA BEACH AMBULATORY SURGERY CENTER | VA | 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 | $545.00 | 1932145109 - VALLEY DIGESTIVE CENTER INC, VALLEY DIGESTIVE HEALTH CENTER | 204484163 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27818 | $1675.00 | 1710060751 - BAY AREA SURGICAL GROUP, INC. | 201198494 - (CA) BAY AREA SURGICAL GROUP, INC. | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27818 | $893.00 | 1134126097 - PHYSICIAN'S SURGERY CENTER OF KNOXVILLE LLC | 621777892 - (TN) PHYSICIANS SURGERY CENTER OF KNOXVILLE LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27818 | $934.00 | 1588610190 - SUMMIT AMBULATORY SURGICAL CENTER, LLC | 522148280 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27818 | $339.00 | 1306503057 - PAIN CARE SURGERY OF LOUISVILLE, LLC | 844317137 - (KY) PAIN CARE SURGERY OF LOUISVILLE LLC | KY | 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 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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