CPT 28039 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 • LT - Left side of body • RT - Right side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 28039 |
National average reimbursement for CPT 28039 by major payers:
$616.67
$671.47
$691.34
$841.52
| 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 28039 | ||||||
United | 28039 | $4617.00 | 1811318785 - CONNECTICUT ORTHOPAEDIC SPECIALISTS OUTPATIENT SURGICAL CENTER LLC | 462819773 | CT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28039 | $862.00 | 1295772101 - CAPE CORAL AMBULATORY SURGERY CENTER, LLC, CAPE CORAL SURGERY CENTER | 202001489 - (FL) CAPE CORAL AMBULATORY SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28039 | $1047.00 | 1386641066 - EYE SURGERY CENTER OF MARYVILLE LLC, EYES OF ILLINOIS SURGERY CENTER | 364111317 - (IL) NOVAMED EYE SURGERY CENTER OF MARYVILLE LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28039 | $5048.00 | 1336391085 - MEMORIAL HERMANN SURGERY CENTER KINGSLAND LLC, MEMORIAL HERMANN SURGERY CENTER KINGSLAND | 263464776 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28039 | $6797.00 | 1053361642 - DEACONESS HOSPITAL, INC. | 350593390 - DEACONESS HOSPITAL INC | IN | General Acute Care Hospital (282N00000X) |
United | 28039 | $1900.00 | 1194264036 - ADVANCED SURGICAL CENTER, LLC | 475144859 - (TX) ADVANCED SURGICAL CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28039 | $1000.00 | 1093778052 - MIDWEST EYE CONSULTANTS, P.C., CLI SURGERY CENTER | 351845786 - (IN) MIDWEST EYE CONSULTANTS, P.C. | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28039 | $1507.00 | 1003575218 - RENAL FOCUS ASC LLC, RENAL FOCUS ASC PLAINVIEW | 863151108 - (NY) RENAL FOCUS ASC LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28039 | $1292.00 | 1801869847 - AESCULAPIAN SURGERY CENTER, LLC, INTERCOASTAL MEDICAL GROUP AMBULATORY SURGERY CENTER | 920179499 - (FL) AESCULAPIAN SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28039 | $1200.00 | 1871026120 - ACCESS CARE PHYSICIANS OF NJ LLC | 203639484 | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28039 | $2050.00 | 1588679179 - SPECIALTY SURGICAL CENTER OF ENCINO LP | 954816334 - (CA) SPECIALTY SURGICAL CENTER OF ENCINO, LP | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28039 | $408.63 | 1083073035 - LILLIAN SILVA | 350593390 - DEACONESS HOSPITAL INC | VA | Certified Registered Nurse Anesthetist (367500000X) |
United | 28039 | $2388.00 | 1912434697 - SUMMIT AMBULATORY SURGICAL CENTER, LLC | 522148280 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28039 | $3742.00 | 1144970807 - MEDICAL CITY SURGERY CENTER SOUTHLAKE, LLC | 881391141 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28039 | $835.00 | 1265770572 - PHILADELPHIA SURGERY CENTER, INC. | 454790325 - (PA) PHILADELPHIA SURGERY CENTER INC | PA | 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 28039 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 28039 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 28039 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 |
|---|---|---|
| 28039-CPT | Moderate | Excision Tumor Soft Tissue Foot Toe Subq 1.5 Cm |
| 28041-CPT | Moderate | Exc Tumor Soft Tissue Foot Toe Subfasc 1.5 Cm |
| 28045-CPT | Moderate | Excision, Tumor, Soft Tissue Of Foot Or Toe, Subfascial (E.G., Intramuscular); Less Than 1.5 Cm |
| 28046-CPT | Moderate | Radical Resection Of Tumor (Eg Sarcoma) Soft Tissue Of Foot Or Toe; Less Than 3 Cm (Revised 01/01/2014) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 28039. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 28039 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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