CPT 27825 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 • 23 - Emergency Room |
| Common Modifiers | • None • RT - Right side of body • LT - Left side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 27825 |
National average reimbursement for CPT 27825 by major payers:
$724.53
$731.39
$773.73
$917.45
| 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 27825 | ||||||
United | 27825 | $2701.00 | 1417912098 - BAILEY SQUARE AMBULATORY SURGICAL CENTER, LTD | 752467365 - (TX) BAILEY SQUARE AMBULATORY SURGICAL CENTER LTD | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27825 | $1875.00 | 1649922485 - NORTHERN LAKES SURGERY CENTER LLC | 874431494 - (MN) NORTHERN LAKES SURGERY CENTER LLC | MN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27825 | $907.00 | 1700887155 - TEXAS MIDWEST SURGERY CENTER, LLC | 752800127 - (TX) TEXAS MIDWEST SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27825 | $564.00 | 1750468583 - TEXAS EYE SURGERY CENTER, LLC | 202928367 - (TX) TEXAS EYE SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27825 | $1258.00 | 1942507488 - GA ENDOSCOPY CENTER, LLC | 273115800 - (GA) GA ENDOSCOPY CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27825 | $783.00 | 1942265939 - INLAND SURGERY CENTER LP | 330018673 - (CA) INLAND SURGERY CENTER LP | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27825 | $2172.00 | 1316359532 - LONE STAR ENDOSCOPY CENTER, LLC | 273635726 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27825 | $1161.00 | 1689748758 - PARK AVENUE SURGERY CENTER LLC | 721565454 - (CO) PARK AVENUE SURGERY CENTER, LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27825 | $1179.00 | 1790252864 - TREASURE COAST ASC, LLC, TREASURE COAST CENTER FOR SURGERY | 384092821 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27825 | $1233.00 | 1366935074 - SKYWAY SURGERY CENTER, LLC | 813237016 - (FL) SKYWAY SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27825 | $1600.00 | 1811936933 - MOORESVILLE HOSPITAL MANAGMENT ASSOCIATES INC, SURGICAL CENTER OF LAKE NORMAN | 592612221 - (NC) MOORESVILLE HOSPITAL MANAGEMENT ASSOCIATES, LLC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27825 | $984.00 | 1548223068 - COLUMBIA SURGICARE OF AUGUSTA, LTD | 621671906 - (GA) COLUMBIA SURGICARE OF AUGUSTA LTD | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27825 | $1206.00 | 1437202249 - PACMED CLINICS | 562290878 - (WA) PACMED CLINICS | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27825 | $637.00 | 1215988308 - MIAMI HAND CENTER, LLC | 650811130 - (FL) MIAMI HAND CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27825 | $839.00 | 1275536393 - MEDICAL CENTER SURGERY ASSOCIATES, LP | 621449272 - (FL) MEDICAL CENTER SURGERY ASSOCIATES LP | FL | 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 27825 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 27825 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 27825 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 |
|---|---|---|
| 27824-CPT | Moderate | Closed Treatment Of Fracture Of Weight Bearing Articular Portion Of Distal Tibia (Eg, Pilon Or Tibial Plafond), With Or Without Anesthesia; Without Manipulation |
| 27825-CPT | Moderate | Closed Treatment Of Fracture Of Weight Bearing Articular Portion Of Distal Tibia (Eg, Pilon Or Tibial Plafond), With Or Without Anesthesia; With Skeletal Traction And/Or Requiring Manipulation |
| 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 |
| 27827-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 Tibia Only |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 27825. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 27825 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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