CPT 27894 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 | • 21 - Inpatient Hospital • 24 - Ambulatory Surgical Center |
| Common Modifiers | • None • RT - Right side of body • LT - Left side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 27894 |
National average reimbursement for CPT 27894 by major payers:
$1,098.99
$1,131.46
$1,140.76
$1,370.98
| 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 27894 | ||||||
United | 27894 | $1800.00 | 1881074102 - HEART AND VASCULAR SURGICAL CENTER, LLC, CHAN HEART RHYTHM INSTITUTE SURGICAL TREATMENT CENTER, LLC | 473598474 - (AZ) HEART AND VASCULAR SURGICAL CENTER LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27894 | $734.00 | 1487651956 - TRI-STATE GASTROENTEROLOGY ASSOCIATES, PSC, TRI-STATE DIGESTIVE DISORDER CENTER | 611192347 - (KY) TRI-STATE GASTROENTEROLOGY ASSOCIATES, PSC | KY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27894 | $2456.00 | 1700807617 - ENDOSCOPY CENTER OF THE ROCKIES LLC, ENDOSCOPY CENTER OF THE ROCKIES LAFAYETTE | 841562782 - (CO) ENDOSCOPY CENTER OF THE ROCKIES LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27894 | $3794.00 | 1225091739 - OUTPATIENT WOMEN'S AND CHILDREN'S SURGERY CENTER, LTD | 432016059 - (TX) OUTPATIENT WOMENS AND CHILDRENS SURGERY CENTER LTD | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27894 | $1455.00 | 1497465249 - CENTRAL WASHINGTON HEALTH SERVICES ASSOCIATION, CONFLUENCE HEALTH MOSES LAKE ASC | 910171250 - CENTRAL WASHINGTON HEALTH SERVICES ASSOCIATION | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27894 | $1250.00 | 1760847792 - OCALA FL ORTHOPAEDIC ASC LLC | 472831130 - (FL) OCALA FL ORTHOPAEDIC ASC, LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27894 | $2072.00 | 1720606932 - PHYSICIANS CLINIC INC | 470687317 - PHYSICIANS CLINIC INC | NE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27894 | $2080.00 | 1326444688 - BRYAN COLLEGE STATION ASC, LP, THE HEART AND VASCULAR SURGERY CENTER | 471615354 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27894 | $2311.00 | 1336209451 - SADDLE RIVER VALLEY SURGICAL CENTER LLC, SADDLE RIVER VALLEY SURGICAL CENTER LLC | 201250583 - (NJ) SADDLE RIVER VALLEY SURGICAL CENTER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27894 | $1400.00 | 1508404922 - ORTHO CENTRAL | 843880872 - (OK) ORTHO CENTRAL | OK | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27894 | $2700.00 | 1700400850 - FALCONHEAD SURGERY CENTER LLC | 844342209 - (TX) FALCONHEAD SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27894 | $2100.00 | 1518423672 - PACIFIC RITZ SURGERY CENTER, LLC | 823738789 - (CA) PACIFIC RITZ SURGERY CENTER LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27894 | $2334.00 | 1669414306 - FREEDOM VISION SURGERY CENTER LLC, FREEDOM VISION SURGERY CENTER LLC | 954673469 - (CA) FREEDOM VISION SURGERY CENTER | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27894 | $3570.00 | 1023349909 - PICCARD SURGERY CENTER, LLC | 270433723 - (MD) PICCARD SURGERY CENTER, LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27894 | $10677.00 | 1730126863 - ST. DAVID'S HEALTHCARE PARTNERSHIP, L.P., LLP, ST. DAVID'S MEDICAL CENTER | 742781812 | 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 27894 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 27894 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 27894 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 |
|---|---|---|
| 27842-CPT | Moderate | Clo Tx Ank Disloc W/Anes W/Wo Fix |
| 27892-CPT | Moderate | Decompression Fasciotomy, Leg; Anterior And/Or Lateral Compartments Only, With Debridement Of Nonviable Muscle And/Or Nerve |
| 27893-CPT | Moderate | Decomp Fasc Leg Post Comp W/Debrid |
| 27894-CPT | High | Decompression Fasciotomy, Leg; Anterior And/Or Lateral, And Posterior Compartment(S), With Debridement Of Nonviable Muscle And/Or Nerve |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 27894. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 27894 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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