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See a sample rate comparisonCPT 28043 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.
Xcision Tumor Sft Tissue Of Foot/Toe Subcutane Less Than 1, Excision Tumor Soft Tissue Of Foot Or Toe Subcutaneous; Less Than 1
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 24 - Ambulatory Surgical Center 11 - Office |
| Common Modifiers | None RT - Right side of body LT - Left side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 28043 |
| Medicaid Fee Schedule | View Medicaid rates for 28043 |
National average reimbursement for CPT 28043 by major payers:
$472.38
$507.08
$525.77
$610.29
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CPT 28043
5 of 25 sample ratesHigher to lower in this preview
Texas Health Presbyterian Hospital Dallas
$3,607.00Published rateWillis Surgicenter, LLC
Willis Surgicenter LLC
$1,152.00Published rateAzendo LLC, Tri-Pointe Surgery Center
Azendo LLC
$947.00Published rateDoctors Clinic A Professional Corporation, The Doctors Clinic Ambulatory Surgery Center
Franciscan Medical Group
$690.00Published rateBaltimore Ambulatory Center For Endoscopy
Baltimore Ambulatory Center Fo
$360.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 28043 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 28043 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 28043 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 |
| 28043-CPT | Moderate | Xcision Tumor Sft Tissue Of Foot/Toe Subcutane Less Than 1, Excision Tumor Soft Tissue Of Foot Or Toe Subcutaneous; Less Than 1 |
| 28045-CPT | Moderate | Xcision Tumor Sft Tissue Of Foot/Toe Subfasci (Eg Intramusc, Excision Tumor Soft Tissue Of Foot Or Toe Subfascial (Eg Intramusc |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 28043. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 28043 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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