CPT 27842 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 27842 |
National average reimbursement for CPT 27842 by major payers:

$655.88

$656.86

$669.93

$826.46
| 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 27842 | ||||||
United | 27842 | $2382.00 | 1801974720 - SUMMIT SURGICAL CENTER, LLC | 731730859 | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27842 | $1375.00 | 1073578019 - BLUE RIDGE DAY SURGERY CENTER, LP, BLUE RIDGE DAY SURGERY CENTER | 621530122 - (NC) BLUE RIDGE DAY SURGERY CENTER LP | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27842 | $600.00 | 1780752352 - PREMIER SURGERY CENTER OF SANTA MARIA LLC | 203502741 - (CA) PREMIER SURGERY CENTER OF SANTA MARIA, INC. | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27842 | $994.00 | 1750568838 - VIVERE HEALTH DALLAS, LLC, VIVERE-DALLAS SURGERY CENTER | 364701304 - (TX) VIVERE HEALTH DALLAS LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27842 | $700.00 | 1598144909 - TRINITY AMBULATORY SURGICAL CENTER LLC, HEART & RHYTHM INSTITUTE OF TRINITY | 472090172 - (FL) TRINITY AMBULATORY SURGICAL CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27842 | $1000.00 | 1346244845 - LAKELAND SURGICAL & DIAGNOSTIC CENTER LLP | 934728316 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27842 | $1664.00 | 1942306816 - OMEGA SURGERY CENTER LLC | 470821405 - (NE) OMEGA SURGERY CENTER LLC | NE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27842 | $1666.00 | 1881667368 - FLORHAM PARK ENDOSCOPY ASC LLC, FLORHAM PARK ENDOSCOPY CENTER | 621774936 - (NJ) FLORHAM PARK ENDOSCOPY CENTER, LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27842 | $3157.00 | 1457379158 - HUDSON CROSSING SURGERY CENTER, LLC, HUDSON CROSSING SURGERY CENTER | 364533553 - (NJ) HUDSON CROSSING SURGICAL CENTER | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27842 | $928.00 | 1881113785 - BANNER ESTRELLA SURGERY CENTER LLC | 901183954 | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27842 | $2197.00 | 1831360247 - SURGICAL CENTER AT COLUMBIA ORTHOPAEDIC GROUP LLC | 261150611 - (MO) SURGICAL CENTER AT COLUMBIA ORTHOPAEDIC GROUP LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27842 | $2003.00 | 1336204668 - PHYSICIANS SURGICENTER LLC | 223550463 - (NJ) PHYSICIANS' SURGICENTER, LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27842 | $1494.00 | 1043746555 - OVERLAND PARK SURGICAL SUITES, LLC | 814367607 - (KS) OVERLAND PARK SURGICAL SUITES LLC | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27842 | $2392.00 | 1972878726 - WILSON CREEK SURGICAL CENTER, LLC, STONEBRIDGE SURGERY CENTER | 274816583 - (TX) WILSON CREEK SURGICAL CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27842 | $1410.00 | 1760440515 - SIERRA ENDOSCOPY CENTER, LLC | 680482297 - (CA) SIERRA ENDOSCOPY CENTER LLC | CA | 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 27842 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 27842 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 27842 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 |
|---|---|---|
| 27840-CPT | Moderate | Red Disloc-Ankle Wo Anesthesia |
| 27842-CPT | Moderate | Clo Tx Ank Disloc W/Anes W/Wo Fix |
| 27846-CPT | High | Open Treatment Of Ankle Dislocation, With Or Without Percutaneous Skeletal Fixation; Without Repair Or Internal Fixation |
| 27848-CPT | High | Open Treatment Of Ankle Dislocation, With Or Without Percutaneous Skeletal Fixation; With Repair Or Internal Or External Fixation |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 27842. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 27842 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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