CPT 27823 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 |
National average reimbursement for CPT 27823 by major payers:
$1,342.88
$1,323.56
$1,388.35
$1,657.20
| 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 27823 | ||||||
United | 27823 | $3225.00 | 1063635506 - DESCHUTES EYE CLINIC INC, EYE SURGERY INSTITUTE | 931148247 - (OR) ORION EYE CENTER, LLC | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27823 | $9476.00 | 1619944824 - WAVERLEY SURGERY CENTER LLC, WAVERLEY SURGERY CENTER | 20554398 - (CA) WAVERLEY SURGERY CENTER, L.P. | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27823 | $2800.00 | 1760991921 - COLUMBIA NEPHROLOGY ASSOCIATES PA | 570702722 - (SC) THE COLUMBIA NEPHROLOGY ASSOCIATES, P.A. | SC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27823 | $5851.00 | 1356965750 - PROLIANCE SURGERY CENTER AT VALLEY, LLC | 842108616 - (WA) PROLIANCE SURGERY CENTER AT VALLEY LLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27823 | $2811.00 | 1437320017 - OREGON EYE SURGERY CENTER, INC. | 930973443 - (OR) OREGON EYE SURGERY CENTER INC | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27823 | $2816.00 | 1497751747 - MID-ATLANTIC ENDOSCOPY CENTER, LLC, MID-ATLANTIC GASTROINTESTINAL CENTER II | 233096335 - (DE) MIDATLANTIC ENDOSCOPY CENTER LLC | DE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27823 | $7888.00 | 1275870537 - GCSA AMBULATORY SURGERY CENTER, LLC | 611699459 - (TX) GCSA AMBULATORY SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27823 | $2980.00 | 1235551052 - LONG ISLAND DIGESTIVE ENDOSCOPY CENTER, LLC | 454714972 | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27823 | $300.00 | 1306964853 - GASTROENTEROLOGY ENDOSCOPY CENTER | 582349040 - (GA) GASTROENTEROLOGY ENDOSCOPY CENTER | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27823 | $2539.00 | 1477507168 - LAKESIDE SURGERY LLC, LAKESIDE SURGERY CENTER | 752714441 - LAKESIDE SURGERY CENTER, LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27823 | $779.95 | 1386074474 - GEORGE DEREFAKA | 350593390 - DEACONESS HOSPITAL INC | FL | Certified Registered Nurse Anesthetist (367500000X) |
United | 27823 | $3515.00 | 1013425933 - REX SURGERY CENTER OF WAKEFIELD, LLC | 465511168 - (NC) REX SURGERY CENTER OF WAKEFIELD LLC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27823 | $2459.00 | 1255345229 - BEACON ORTHOPAEDICS SURGERY CENTER, LLC, SUMMIT SURGERY CENTER | 311800570 - (OH) BEACON ORTHOPAEDICS SURGERY CENTER LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27823 | $8087.00 | 1952331092 - MEMORIAL HERMANN SURGERY CENTER SUGAR LAND LLP | 203233617 - (TX) MEMORIAL HERMANN SURGERY CENTER SUGAR LAND LLP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27823 | $3985.00 | 1649252883 - FOUNDATION SURGERY AFFILIATE OF NACOGDOCHES LLC, NACOGDOCHES SURGERY CENTER | 731589339 - (TX) FOUNDATION SURGERY AFFILIATE OF NACOGDOCHES LLC | TX | 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 27823 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 27823 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 27823 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 |
|---|---|---|
| 27816-CPT | Moderate | Clo Tx Trimalleolar Ank Fx Wo Manip |
| 27818-CPT | Moderate | Tx Closed Trimalleolar Ankle Fx;W Manipu |
| 27822-CPT | High | Open Treatment Of Trimalleolar Ankle Fracture, Includes Internal Fixation, When Performed, Medial And/Or Lateral Malleolus; Without Fixation Of Posterior Lip |
| 27823-CPT | High | Open Treatment Of Trimalleolar Ankle Fracture, Includes Internal Fixation, When Performed, Medial And/Or Lateral Malleolus; With Fixation Of Posterior Lip |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 27823. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 27823 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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