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See a sample rate comparisonCPT 28011 Fee Schedule
Last Verified: October 2026
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.
Tenotomy Toe Subcutan Multiple
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 11 - Office 24 - Ambulatory Surgical Center |
| Common Modifiers | None 59 - Distinct Procedural Service T7 - Right foot, third digit |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 28011 |
| Medicaid Fee Schedule | View Medicaid rates for 28011 |
National average reimbursement for CPT 28011 by major payers:
$422.75
$433.37
$439.84
$526.28
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CPT 28011
5 of 25 sample ratesHigher to lower in this preview
Baycare Aurora Kaukauna Surgery Center LLC, Kaukauna Surgery Center
Baycare Aurora Kaukauna Surgery Center LLC
$7,810.00Published rateSurgcenter Of Silver Spring, LLC
Surgcenter Of Silver Spring LLC
$1,840.00Published rateSalem Endoscopy Center, LLC
Salem Endoscopy Center LLC
$1,469.00Published rateSouthwest Medical Associates, Inc, Southwest Medical Associates - Tenaya
$1,282.00Published rateNorth Valley Endoscopy Center LLC
$774.00Published rate
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See a sample payer proposalCPT 28011 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 28011 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 28011 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 |
|---|---|---|
| 28011-CPT | Moderate | Tenotomy Toe Subcutan Multiple |
| 28020-CPT | Moderate | Arthrotomy Including Explorat, Arthrotomy Including Exploration Drainage Or Removal Ofloose Or Foreign Body Intertarsal Or Tarsometatarsal Joint Arthrotomy Including Exploration Drainage Or Removal Of |
| 28024-CPT | Moderate | Arthrotomy Including Explorat, Arthrotomy Including Exploration Drainage Or Removal Ofloose Or Foreign Body Interphalangeal Joint Arthrotomy Including Exploration Drainage Or Removal Of |
| 28070-CPT | Moderate | Synovectomy Intertarsal Or Ta, Synovectomy Intertarsal Or Tarsometatarsal Jointeachsynovectomy Intertarsal Or Tarsometatarsal J Oint Each |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 28011. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 28011 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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