CPT 27831 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 • RT - Right side of body • LT - Left side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 27831 |
National average reimbursement for CPT 27831 by major payers:
$578.09
$531.40
$556.16
$682.40
| 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 27831 | ||||||
United | 27831 | $900.00 | 1477792828 - PRECISION SURGICENTER LLC | 262185162 - (CA) PRECISION SURGICENTER, LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27831 | $218.00 | 1396828323 - EYE CARE SURGERY CENTER OF MEMPHIS, LLC | 470920340 | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27831 | $650.00 | 1588679179 - SPECIALTY SURGICAL CENTER OF ENCINO LP | 954816334 - (CA) SPECIALTY SURGICAL CENTER OF ENCINO, LP | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27831 | $443.00 | 1871591248 - NOVAMED SURGERY CENTER OF NASHUA, LLC, NASHUA EYE SURGERY CENTER | 770618679 - (NH) NOVAMED SURGERY CENTER OF NASHUA LLC | NH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27831 | $333.00 | 1447225503 - BAPTIST DESOTO SURGERY CENTER, LP | 200804946 - (MS) BAPTIST DESOTO SURGERY CENTER LP | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27831 | $1182.00 | 1457370447 - ORTHOPEDIC ASSOCIATES SURGERY CENTER LLC | 200446252 - (CT) ORTHOPEDIC ASSOCIATES SURGERY CENTER LLC | CT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27831 | $386.00 | 1811929300 - COASTAL DIGESTIVE CARE CENTER LLC | 20621976 - (CT) COASTAL DIGESTIVE CARE CENTER LLC | CT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27831 | $788.00 | 1982782934 - GREATER LAFAYETTE HEALTH SERVICES, UNITY SURGICAL CENTER | 352099067 - (IN) UNITY SURGICAL CENTER LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27831 | $402.00 | 1831665983 - WAXAHACHIE SURGERY CENTER | 831268553 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27831 | $305.00 | 1356369755 - MADISON SURGERY CENTER, LLC | 631249522 - (AL) MADISON SURGERY CENTER, L.L.C. | AL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27831 | $286.00 | 1679534614 - COURTYARD SURGERY PAVILION, INC, COURTYARD SURGERY PAVILION | 731728117 - (CA) COURTYARD SURGERY PAVILION INC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27831 | $557.00 | 1053508077 - JOURNEY LITE OF CINCINNATI, LLC | 208861350 - (OH) JOURNEYLITE OF CINCINNATI, LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27831 | $1139.00 | 1609400290 - ORTHOPAEDIC ASSOCIATES OF CENTRAL TEXAS SURGERY CENTER, LLC | 844818321 - (TX) ORTHOPAEDIC ASSOCIATES OF CENTRAL TEXAS SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27831 | $469.00 | 1972556942 - CHERRY HILL WOMEN'S CENTER, INC. | 232068660 - (NJ) CHERRY HILL WOMENS CENTER INC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27831 | $725.00 | 1720033293 - CLINIC SURGERY CENTER, LLC, NEW TAMPA SURGERY CENTER | 883196649 - (FL) CLINIC SURGERY CENTER LLC | 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 27831 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 27831 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 27831 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 |
|---|---|---|
| 27781-CPT | Moderate | Tx Closed Proximal Fibulaor Shaft Fx;W |
| 27784-CPT | Moderate | Red Fx Open-Fibula |
| 27828-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 Both Tibia And Fibula |
| 27831-CPT | Moderate | Tx Proximal Tibiofibular Joint Disloc;W |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 27831. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 27831 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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