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See a sample rate comparisonHealthcare 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 | 21 - Inpatient Hospital 22 - On Campus Outpatient Hospital |
| Common Modifiers | None RT - Right side of body LT - Left side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 27828 |
| Medicaid Fee Schedule | View Medicaid rates for 27828 |
National average reimbursement for CPT 27828 by major payers:

$1,778.86

$1,767.14

$1,872.56

$2,156.87
Choose a payer to see a sample of rates for CPT 27828.
Orthoatlanta Surgery Center Of Fayetteville LLC
Bethesda Endoscopy Center LLC
Bergen Gastroenterology, P.C.
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Rate Benchmarking
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See a sample rate comparisonPayer Contract Negotiation
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 27828 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 27828 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 27828 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 O, Closed Treatment Of Fracture Of Weight Bearing Articularportion Of Distal Tibia (Eg Pilon Or Tibialplafond) With Or Without Anesthesia Without Manipulation |
| 27825-CPT | Moderate | Treat Lower Leg Fracture, 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 | Surgical Repair Of Broken Leg, Surgery To Repair A Break In The Weight-Bearing Portion Of One Or Both Bones In The Lower Leg (Tibia Or Fibula). Pins Wires Screws Or Plates May Be Used To Hold The Bones In Place. |
| 27828-CPT | High | Surgical Repair Of Broken Leg, Surgery To Repair A Break In The Weight-Bearing Portion Of One Or Both Bones In The Lower Leg (Tibia Or Fibula). Pins Wires Screws Or Plates May Be Used To Hold The Bones In Place. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 27828. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 27828 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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