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 |
| Medicaid Fee Schedule | View Medicaid rates for 28039 |
National average reimbursement for CPT 28039 by major payers:
$616.67
$671.47
$691.34
$601.38
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 | Xcision Tumor Sft Tissue Of Foot/Toe Subcutane 1.5 Cm Or G, Excision Tumor Soft Tissue Of Foot Or Toe Subcutaneous; 1.5 Cm Or G |
| 28041-CPT | Moderate | Xcision Tumor Sft Tissue Of Foot/Toe Subfasci (Eg Intramusc, Excision Tumor Soft Tissue Of Foot Or Toe Subfascial (Eg Intramusc |
| 28045-CPT | Moderate | Xcision Tumor Sft Tissue Of Foot/Toe Subfasci (Eg Intramusc, Excision Tumor Soft Tissue Of Foot Or Toe Subfascial (Eg Intramusc |
| 28046-CPT | Moderate | Radical Resct Of Tumor (Eg Sarcom) Sft Tissue Of Foot/Toe;, Radical Resection Of Tumor (Eg Sarcoma) Soft Tissue Of Foot Or Toe; |
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.
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 28039) and we'll show you how you compare in 15 minutes or less.