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See a sample rate comparisonCPT 28020 Fee Schedule
Last Verified: September 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.
Arthrotomy Including Explorat, Arthrotomy Including Exploration Drainage Or Removal Ofloose Or Foreign Body Intertarsal Or Tarsometatarsal Joint Arthrotomy Including Exploration Drainage Or Removal Of
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 24 - Ambulatory Surgical Center 22 - On Campus Outpatient Hospital |
| Common Modifiers | None RT - Right side of body LT - Left side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 28020 |
| Medicaid Fee Schedule | View Medicaid rates for 28020 |
National average reimbursement for CPT 28020 by major payers:
$678.91
$703.33
$742.91
$628.47
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CPT 28020
5 of 25 sample ratesHigher to lower in this preview
Senate Street Surgery Center LLC, Clarian Health Partners Inc Mbr
Senate Street Surgery Center LLC
$8,705.00Published rateMedina-Summit Ambulatory Surgery Center, The Medina Surgery Center
Summa Health, Pension Administation Committee
$1,882.00Published rateNaperville Fertility Center, Inc.
$1,201.00Published rateWestern Washington Endoscopy Centers LLC, Peninsula Endoscopy Center
Western Washington Endoscopy Centers LLC
$986.00Published rateDigestive Health Complex,Inc
$530.00Published rate
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See a sample payer proposalCPT 28020 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 28020 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 28020 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 |
|---|---|---|
| 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 |
| 28022-CPT | Moderate | Arthrotomy Including Explorat, Arthrotomy Including Exploration Drainage Or Removal Ofloose Or Foreign Body Metatarsophalangealjoint Arthrotomy Including Exploration Drainag E Or Removal Of |
| 28050-CPT | Moderate | Biopsy Of Joint In Foot, Surgery To Explore A Foot Joint. The Procedure Includes Removing A Tissue Sample For Testing (Biopsy). |
| 28054-CPT | Moderate | Remove Toe Tissue Sample, Surgery To Explore A Toe Joint. The Procedure Removes A Sample Of Tissue For Testing (Biopsy). |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 28020. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 28020 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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