CPT 28047 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address high-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 | • 22 - On Campus Outpatient Hospital • 24 - Ambulatory Surgical Center |
| Common Modifiers | • None • LT - Left side of body • RT - Right side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 28047 |
National average reimbursement for CPT 28047 by major payers:
$1,304.90
$1,392.74
$1,385.88
$1,737.89
| 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 28047 | ||||||
United | 28047 | $1350.00 | 1073155834 - REGENCY AMBULATORY SURGERY CENTER ONE, LLC | 843154819 | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28047 | $1864.00 | 1942292545 - CAPITAL REGION AMBULATORY SURGERY CENTER, L.L.C. | 141819902 - (NY) CAPITAL REGION AMBULATORY SURGERY CENTER LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28047 | $2388.00 | 1295860302 - GOLD COAST SURGERY CENTER LLC, GULF COMPREHENSIVE SURGERY CENTER | 203958739 - (FL) GOLD COAST SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28047 | $770.00 | 1487629986 - SAN LUIS OBISPO CA ENDOSCOPY ASC LP, ENDOSCOPY CENTER OF THE CENTRAL COAST | 201965605 - (CA) SAN LUIS OBISPO CA ENDOSCOPY ASC LP | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28047 | $1220.00 | 1528622321 - PREMIER-COVENANT ASTC LLC, PREMIER AMBULATORY SURGERY CENTER | 834550993 - (TN) PREMIERCOVENANT ASTC LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28047 | $2007.00 | 1386275147 - SURGERY CENTER OF MESA LLC | 813829555 - (AZ) SURGERY CENTER OF MESA LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28047 | $2750.00 | 1194489757 - WALNUT CREEK SURGICAL SUITES, LLC | 852525715 - (OH) WALNUT CREEK SURGICAL SUITES LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28047 | $1505.00 | 1538432844 - BARNET DULANEY PERKINS EYE CENTER, PC, AMERICAN VISION PARTNERS | 562589722 - BARNET DULANEY PERKINS EYE CENTER PLLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28047 | $3091.73 | 1124022595 - THE OUTPATIENT SURGERY CENTER OF CEDAR RAPIDS, LLC, SURGERY CENTER CEDAR RAPIDS | 721550812 - (IA) THE OUTPATIENT SURGERY CENTER OF CEDAR RAPIDS LLC | IA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28047 | $1162.00 | 1366484776 - DUTCHESS SURGICAL CENTER | 141803011 - (NY) DUTCHESS AMBULATORY SURGICAL CENTER | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28047 | $1240.00 | 1750884052 - PRECISION SURGERY CENTER PLLC | 824729968 - (ID) PRECISION SURGERY CENTER PLLC | ID | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28047 | $1203.00 | 1740254572 - THE NORTHERN NV ENDOSCOPY ASC LLC, DIGESTIVE HEALTH CENTER | 200470103 - THE NORTHERN NV ENDOSCOPY ASC LLC | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28047 | $3055.00 | 1407981327 - ARIA HEALTH TORRESDALE -SPU | 230596940 - (PA) JEFFERSON HEALTH-NORTHEAST | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28047 | $2859.00 | 1114202892 - ALVARADO EYE SURGERY CENTER LLC | 453181784 - (CA) ALVARADO EYE SURGERY CENTER LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 28047 | $2044.00 | 1881659613 - WEST HILLS SURGICAL CENTER LTD | 621625014 - (CA) WEST HILLS SURGICAL CENTER LTD | CA | 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 |
Want to see your competitors' rates?
Start your trial today to unlock complete access to provider rates and fee schedules in your area.
Here's what you can do with PayerPrice
Renegotiate your managed care contracts
Benchmark your current rates against market averages to identify opportunities for rate optimization.
Prospect for new business using fee schedules
Access every provider's negotiated rates for every billing code in your market to inform your prospecting strategies.
Integrate real-time payer data into your workflows
Automatically keep fee schedules up-to-date without adding yet another log-in to your insurance systems. Connect via API or SQL.
PayerPrice shows you the exact negotiated rates that insurers publish under federal transparency rules.
We display the raw data directly from insurers' files, giving you the same information they make public. Learn more about Price Transparency.
CPT 28047 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 28047 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 28047 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 |
|---|---|---|
| 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) |
| 28047-CPT | High | Radical Resection Of Tumor (Eg Sarcoma) Soft Tissue Of Foot Or Toe; 3 Cm Or Greater (Revised 01/01/2014) |
| 28171-CPT | High | Radical Resection Of Tumor Bone; Tarsal (Except Talus Or Calcaneus) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 28047. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 28047 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 28047) and we'll show you how you compare in 15 minutes or less.