CPT 28024 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 | 24 - Ambulatory Surgical Center 22 - On Campus Outpatient Hospital |
| Common Modifiers | None 59 - Distinct Procedural Service LT - Left side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 28024 |
| Medicaid Fee Schedule | View Medicaid rates for 28024 |
National average reimbursement for CPT 28024 by major payers:
$577.66
$600.71
$616.19
$529.80
CPT 28024 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 28024 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 28024 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 |
| 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 |
| 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 28024. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 28024 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.
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 28024) and we'll show you how you compare in 15 minutes or less.